14. Psychological Wellbeing

Psychological wellbeing is typically viewed as comprising hedonic (feeling good) and eudaimonic (functioning well) components. The emphasis given to each of these varies between conceptualisations. Seligman (2002) proposed the concept of ‘authentic happiness’, which consists of pleasure, engagement and meaning. More recently, the concepts of relationships and accomplishment have been added (Forgeard et al., 2011; Seligman, 2010; 2011,) leading to the acronym ‘PERMA’, which stands for positive emotion, engagement, relationships, meaning and accomplishment. Others have argued that positive human experience is only related to hedonic wellbeing, positive emotion, the absence of negative emotions and an evaluative component termed ‘life satisfaction’ (Diener et al., 1999). More recently, Diener and colleagues (2010) added the concept of ‘flourishing’, which includes purpose in life, positive relationships, engagement, competence, self-esteem, optimism and contribution to the wellbeing of others. Despite these different conceptualisations, there is agreement that wellbeing is multi-dimensional. Approaching the conceptualisation of wellbeing from a different perspective, Huppert and So (2013) equated high levels of wellbeing with positive mental health. They argue that wellbeing lies at the opposite end of the spectrum to common mental disorders, depression and anxiety. By examining internationally agreed criteria for depression and anxiety and defining the opposite of each symptom, they identified features of positive wellbeing which combined feeling and functioning. The elements that emerged were:

competence, concentration, attention, decision-making, general competence;
emotional stability, feeling calm, relaxed, even-tempered;
engagement, interest, pleasure, enjoyment;
meaning, purpose, worth, value in life;
positive relationships, social relationships, positive affirmation;
optimism, hopeful for the future;
positive emotion, positive mood, happy, cheerful and contented;
resilience, managing anxiety and worry, emotional resilience;
Self-esteem, feelings of self-worth, confidence;
vitality, feeling energetic, not fatigued or lethargic;
life satisfaction, positive appraisal of life in general.

Previous chapters have set out the role that music can play in relation to many of these elements, including competence, engagement, positive relationships, self-esteem and (to a lesser extent) resilience and optimism. Some elements can be met by active engagement with music, and others through listening to music, although there is overlap between these. Actively making music offers the most opportunities for supporting competence, self-esteem and resilience, while listening to music is more likely to support emotional stability and positive emotions. Both can support engagement, meaning, optimism, positive relationships and vitality.

There is an ever-increasing body of research on the benefits of engaging with music in relation to psychological wellbeing. This chapter will consider the impact of listening to and actively engaging with music through the different phases of the lifespan. Positive associations between engaging with music and wellbeing have been demonstrated in early childhood (Linnavalli et al., 2018; Trainor et al., 2012), in terms of children’s educational outcomes (Guhn et al., 2019), sense of social inclusion (Welch et al., 2014) and social cohesion (Elvers et al., 2016), in adolescence (McFerran et al., 2019), adulthood (Greasley and Lamont, 2006), older age (Laukka, 2007; Lindblad and de Boise, 2020) and overall development (Biasutti et al., 2020). Drawing conclusions about the research is not without its difficulties. For instance, in a recent review, Daykin and colleagues (2018) pointed out that there was a lack of consistency in how wellbeing was assessed and in the range of musical interventions implemented. Overall, they reported that music was associated with reduced anxiety in young adults, enhanced mood and purpose in adults, and mental wellbeing, quality of life, self-awareness and coping in people with diagnosed health conditions. Music listening and singing were shown to be effective in enhancing morale and reducing risk of depression in older people, while a few studies addressed wellbeing in individuals with dementia. Sheppard and Broughton (2020) also reviewed the literature and showed that music and dance were related to key social determinants of health from social, cultural, physical and mental health perspectives. Similarly, O’Donnell and colleagues (2021), in a systematic review which included 32 studies with 1,058 participants focusing on wellbeing in adults over 18 years of age, showed that participatory arts interventions benefited mental health through improved connectedness, emotional regulation, meaning-making and redefining identity, personal growth and empowerment. Benefits relating to wellbeing have been found, whether individuals volunteer to participate or are referred by health or social care professionals. Music has been recognised for its beneficial effects on physical health (Fancourt and Finn, 2019; Hanser, 2010; Jones et al., 2013; MacDonald et al., 2012; Pelletier, 2004; van den Elzen et al., 2019). Research focusing on the way that music has been used in medical contexts will be discussed in Chapter 15. The remainder of this chapter will set out the way in which music can enhance wellbeing and consider its role across the lifespan from infancy, through the school years, adolescence, young adulthood, the adult years and into older age, concluding with a section on music and wellbeing in the COVID-19 pandemic.

The impact of music on psychological wellbeing and good health is largely, although not exclusively, through the emotions it evokes. Music elicits emotions and changes moods through its stimulation of the autonomic nervous system and limbic and related biological systems, including endocrine and hormonal responses (Krout, 2007). Bodily responses linked with emotion include changes in dopamine, serotonin, cortisol, endorphin and oxytocin levels (Kreutz et al., 2012) and cardiovascular indicators, blood pressure and pulse (Lee et al., 2016). Some changes in response to music can occur without an individual’s conscious awareness. In two multilevel meta-analyses of 104 studies with 9,617 participants, de Witte and colleagues (2019) showed that interventions using music had an overall significant positive effect on stress reduction, physiologically and psychologically, although greater effects were found for heart rate when compared to blood pressure. Overall, music can reduce stress and increase relaxation (Fukui and Yamashita, 2003; Kreutz et al., 2004) but the outcomes depend on the nature of the music (Kimberley et al., 1995). For instance, Gerra and colleagues (1998) investigated emotional and endocrine changes in response to listening to techno music. Sixteen young people were exposed to techno or classical music for 30 minutes each. Concentrations of plasma norepinephrine, epinephrine, growth hormone, prolactin, adrenocorticotropic hormone, cortisol and β endorphin were assessed before and after the listening activity. Techno music significantly increased heart rate and systolic blood pressure, and led to changes in the assessed neurotransmitters, peptides and hormones related to mental state and emotional involvement. Classical music also enhanced emotional state, but did not lead to significant changes in hormonal concentrations. Similarly, Evers and Suhr (2000), working with adults, investigated the short-term effects of listening to different musical excerpts on serum concentrations of prolactin, adrenocorticotropic hormone and serotonin, the latter contributing to feelings of wellbeing. Some excerpts were characterised as pleasant—for instance, Brahms’ ‘Symphony No. 3, Opus 90’—while others were perceived as unpleasant (for instance, Penderecki’s ‘Threnos’, which is in part composed in quarter tones to exaggerate the dissonance of the music). Listening to Threnos led to a reduction in concentrations of serotonin, suggesting a negative impact on wellbeing.

The most comprehensive attempt to outline the mechanisms that may underpin music’s impact on the emotions is the BRECVEMA framework (Juslin, 2013). This features eight mechanisms through which music affects emotions:

Brain stem reflex: a hard-wired attention response to simple acoustic features such as extreme or increasing loudness or speed (Juslin et al., 2014);
Rhythmic entrainment: a gradual adjustment of an internal body rhythm—for instance, heart rate—towards an external rhythm in the music (Harrer & Harrer, 1977);
Evaluative conditioning: a regular pairing of a piece of music and other positive or negative stimuli leading to a conditioned association (Blair and Shimp, 1992);
Emotional contagion: perception of emotionally relevant expressions in the music which is then copied (Juslin, 2000; Lundqvist et al., 2009);
Visual imagery: images with emotional qualities evoked by the music (Osborne, 1981);
Episodic memory: a conscious recollection of a particular event from the listener’s past triggered by the music (Baumgartner, 1992);
Musical expectancy: a reaction to the gradual unfolding of the musical structure and its expected or unexpected continuation (Meyer, 1956); and
Aesthetic judgment: a subjective evaluation of the aesthetic value of the music based on an individual set of weighted criteria (Juslin and Sloboda, 2010).

The specific way in which emotions are invoked depends on complex interactions between the nature of the music, the individual and the context. Individual preferences play a major role. The more that the individual is familiar with particular genres or pieces of music, the more they are preferred (North and Hargreaves, 2008). This process begins in early childhood. This explains why music that is pleasurable for some individuals may be unpleasant for others. The greatest positive benefits of music on wellbeing and health occur when individuals are able to select the music that they are to listen to (Krause et al., 2015; Mitchell et al. 2006a; 2006b). This is particularly important when music is being used to reduce anxiety or pain (Bernatzky et al., 2012; Mitchell and MacDonald, 2012). If individuals are exposed to music that they do not like in contexts where they have no control, they may remove themselves from the situation, but if that is not possible, the music can cause extreme distress. Although individuals react to music in different ways, there are some musical characteristics which tend to have a relatively consistent effect on arousal levels (which are implicated in emotional responses). Quiet, slow music tends to lead to a lowering of arousal levels, while fast and loud music tends to increase arousal (North and Hargreaves, 2008).

Music can engender intense, strong emotional experiences. These generally occur when listening to music rather than performing (Gabrielsson, 2001, 2002, 2011; Gabrielsson and Lindström Wik, 2003). Such experiences have overall general characteristics including physical reactions and behaviours; perceptual and cognitive responses; changes in feelings and emotions; existential and transcendental aspects; and personal and social aspects. Individuals report sensations of joy, happiness, rapture, euphoria, calm and peace which have high significance and can lead to long-term benefits, with lives becoming more fulfilling, spiritual and increasingly harmonious (Schäfer et al., 2014) with a positive impact on wellbeing (Lamont, 2011; 2012). Memories of such experiences can be used as sources for self-therapy, inspiration and motivation, and provide insights into alternative ways of being (Gabrielsson, 2011; Gabrielsson and Lindström, 1995). Most occur in adolescence and early adulthood (Gabrielsson and Lindström Wik, 2003).

The Use of Music to Support Emotional Stability and Manage Moods

A key human ability is the capacity to regulate emotion, modifying positive or negative aspects, intensity and time course (Barrett and Gross, 2001; Cole et al., 2004), physiological processes, and emotion-related behaviour (Eisenberg, 2004; Eisenberg and Spinrad, 2004; Gross, 1998). Emotional self-regulation also includes the management of moods which are generally differentiated from emotions in terms of their longer duration, lack of specific cause and greater focus on internal experiences rather than overt behaviour (Gross, 2015). Mood regulation refers to the processes involved in modifying or maintaining the occurrence, duration, and intensity of moods (Cole et al., 2004; Eisenberg and Spinrad, 2004; Gross, 1998).

Music can promote subjective feelings of wellbeing, provide a means of working through difficult emotions, and is often linked to spirituality (Juslin and Sloboda, 2001). It is frequently used as a regulatory strategy for maintaining or changing moods, emotions, arousal levels and to reminisce (DeNora, 1999; Juslin and Laukka, 2004; Parker and Brown, 1982; Rippere, 1977; Schäfer et al., 2013; Silk, 2003; Thayer et al., 1994). It can induce positive affective states (North et al., 2004), help to achieve desired moods—whatever they may be (Vastfjall, 2002) and act as a supporting strategy when coping with negative moods and emotions (Miranda and Claes, 2009; Shifriss and Bodner, 2015). It may be that this is one of the reasons why music plays such an important role in the lives of most people (Sloboda et al., 2009). Certainly, mood regulation is reported to be one of the most important reasons why people listen to music (Christenson and Roberts, 1998; North et al., 2000; Sloboda and O’Neill, 2001; Wells & Hakanen, 1991). Even adolescents who play an instrument report that the best activity for mood regulation is listening to music alone (Saarikallio, 2006). Music is used for self-regulation by adolescents (Behne, 1997; Laiho, 2004; Roe, 1985), adults (Greasley and Lamont, 2006), and the elderly (Davidson et al., 2008). It can be used to maintain positive moods, for revival and energising, to create strong sensations, as a diversion, as discharge, for mental work, for solace and for psyching up (Saarikallio, 2011).

The extent to which music relates to wellbeing has been demonstrated in several reviews. For instance, Schäfer and colleagues (2013) identified 129 functions of listening to music. Ratings by 834 respondents led to the emergence of three underlying dimensions: listening to music to regulate arousal and mood, achieving self-awareness, and as an expression of social relatedness. Similarly, Krause and colleagues (2018) identified 2,075 benefits of music based on a review of 97 published articles. These were reduced to 562 benefits to wellbeing which were perceived to be associated with musical participation. From these, five dimensions were identified: mood and coping, self-esteem and worth, socialisation, cognition and self-actualisation. Saarikallio and colleagues (2018) collected data from 464 online participants and established that the pleasure derived from music was based in part on sensations of relaxation, power and passion, but also feelings of kinship relating to social values and mental contemplation. Reminiscence is also a frequent function of self-chosen music listening. This is particularly prevalent in older adults (Hays and Minichiello, 2005; Juslin and Laukka, 2004), although it is also found in young people (Tolfree and Hallam, 2016). Overall, music is one form of attending to and reappraising emotional experiences (Ruud, 1998; Sloboda and O’Neill, 2001). Van Goethem and Sloboda (2011) carried out diary studies alongside interviews and established that music helped individuals through the use of several regulation strategies. For instance, it could help to distract someone from an emotion or a situation, or help to consider either in a rational way. It plays a major role in assisting relaxation and promoting happiness.

Cognitive reappraisal seems to play an important role in the way that music impacts on wellbeing. If listening to music, making music and social engagement are coupled with a tendency to regulate emotions and thoughts by suppressing emotion, there may be negative outcomes. Suppressing outward expressions of emotions does not decrease negative feelings and emotional arousal. High levels of engagement with music through listening or participating have been associated with a greater use of cognitive reappraisal. This may be because music provides a safe platform for exploring and expressing emotions, positive and negative (Huron, 2006). In this way, the process of emotion regulation may act to mediate the relationship between musical engagement and wellbeing (Chin and Rickard, 2012).

Thoma and colleagues (2012) demonstrated a clear preference for music congruent with the specific emotional situation of the individual at the time, while Randall and colleagues (2014) suggested that listeners adopted particular regulation strategies based on their initial mood, emotional wellbeing and health which would enable them to reach their desired emotional goal. Similarly, Randall and Rickard (2017b), in research with 327 young adults, concluded that music listening was determined by initial mood and emotional health with the aim of fulfilling specific emotional needs. Randall and Rickard (2017a), based on data from research with 195 participants, demonstrated that generally music returned moods to a neutral state, although sometimes music was selected which was congruent with a current mood. Where music was used to cope with very difficult situations or forget problems, it tended to be associated with overall negative affective states and poor emotional health and wellbeing. In a critical analysis, McFerran (2016) suggested that the use of music to maintain negative moods by seriously distressed individuals could lead to increasingly negative outcomes.

As research has developed over time, inconsistencies in terms of conceptualisation and terminology have emerged (Baltazar and Saarikallio, 2016). It has become clear that the impact of music on wellbeing is not straightforward. For instance, Kantor-Martynuska (2015) suggested that the way that individuals respond to music depends on an interaction between the properties of the music, the relatively stable traits of the listener, his or her current emotional state and their current situation. A considerable body of research has focused on why individuals choose to listen to sad music (Huron and Vuoskoski, 2020; Tahlier et al., 2013; Van den Tol and Edwards, 2015). For instance, Sachs and colleagues (2015) suggest that listening to sad music can bring about positive change by correcting an ongoing homeostatic imbalance. They argue that sadness evoked by music is pleasurable when it is perceived as non-threatening, is aesthetically pleasing and produces psychological benefits such as mood regulation and empathic feelings caused, for instance, by recollection of and reflection on past events. Garrido and colleagues, in several studies, also explored why people listen to sad music (Garrido, 2017; Garrido and Schubert, 2013). Garrido and Schubert (2015a) studied 335 participants who listened to a self-selected piece of sad music. They found that participants’ depression increased after listening. Similarly, Garrido and Schubert (2015b), studying 175 university students who listened to a self-selected piece of music on YouTube, found that listening could significantly increase depressive feelings in those with depressive tendencies. In an online survey of 137 participants, Garrido and Schubert (2013) showed that listening to sad music could have adaptive or maladaptive uses. They explained this by the dissociation theory of aesthetic enjoyment, where participants with the capacity to enter states of absorption are able to deactivate displeasure circuits and hence enjoy negative emotions in music. Garrido and colleagues (2017) explored these issues further, investigating whether listening to sad music in group settings provided social benefits for emotionally vulnerable listeners, or whether it further exaggerated depressive tendencies. Six hundred and ninety-seven participants aged 16 to 74 years of age were recruited through online depression groups and mental health websites in the USA, Australia, the UK, South America, Africa, Asia and Europe. A survey of listening habits revealed that participants with depression were more likely to engage in group rumination (the process of continuously thinking the same thoughts, usually sad and dark). Those with depressive tendencies seem to struggle to regulate their emotional responses in musical contexts (McFerran, 2016) and group interactions focusing on sad music exacerbated these difficulties (Miranda et al., 2012). Rose (2002) described this extensive discussion and revisiting of problems among friends as co-rumination. Conversely, the sharing of emotions through music listening may provide individuals with depressive tendencies with social support and thus increase their sense of connection with others. Reflection as opposed to rumination can, it seems, be a useful tool for processing negative emotions (Trapnell and Campbell, 1999). Individuals who have already acquired adaptive coping strategies—for instance, seeking social support—may use group music listening positively to provide support and help them process negative feelings. These findings are important for the use of music in healthcare settings and wellbeing in everyday life (Garrido, 2017).

One strand of research has explored differences between individuals in the ways that music impacts on wellbeing. For instance, Leipold and Loepthien (2015), drawing on data from 521 participants aged 18 to 86 years old and 152 adolescents and young people aged 12 to 23 years old, studied the differences between attentive analytical listening (which was defined as reflective and complex) and emotional listening, and the relationships of these with coping with stress or rumination. They showed that attentive analytical listening to music showed positive relationships to accommodative coping, whereas emotional listening had a positive relationship with rumination. No age differences were found in the nature of listening in adulthood or for the younger age group, although the transition from adolescence to adulthood was important. A comparison between adolescents and young adults revealed that attentive analytical listening was negatively associated with age up to approximately 17 years old, after which the relationship became positive, while adolescents demonstrated age increments in emotional listening.

Similarly, Groarke and Hogan (2016) asked 24 younger people and 19 older adults why they listened to music. The younger adults emphasised affect regulation and social connection, whereas older adults emphasised more eudaimonic (well-functioning) uses of music: for instance, transcendence and personal growth. Saarikallio (2011) found that older people were more aware of how music fitted particular moods and situations. Women have been found to be more likely to use music to regulate emotions and moods than men (Sloboda, 1999). There is evidence that girls are more likely to engage with music to cope with personal problems and interpersonal conflicts, whereas for boys, music is a way of increasing energy levels and positive moods, and creating an impression of being cool (Behne, 1997; Christenson and Roberts, 1998; Larson, 1995; Larson et al., 1989. Music can be effective in decreasing arousal due to stress, particularly for adolescents, females and musicians (Pelletier, 2004). For instance, Lehmann (1997) reported that music majors responded more strongly emotionally to their preferred music than non-music majors, although some studies have reported that the music-related emotional experiences of non-musicians and musicians are broadly similar (Schubert, 2001).

The use of music to regulate moods is related to musical preferences. Diversity in musical preference has been shown to be related to emotionality in listening (Behne, 1997; Schwartz and Fouts, 2003). Preference for harder forms of music has been found to be positively related to emotional problems, including psychological turmoil and behavioural problems (Took and Weiss, 1994) expression of anger (Epstein et al., 1990), feelings of loneliness (Davis and Kraus, 1989) and moodiness, pessimism and impulsiveness (Schwartz and Fouts, 2003). Ter Bogt and colleagues (2020) addressed the potential link between liking goth music and depressive symptoms in a four-year study of 10- to 15 –year-olds. They showed that goth music was liked by a small minority of adolescents, who reported increased levels of depressive symptoms as they grew older. In contrast, preference for upbeat and conventional pop music has been found to be negatively related to depression (Rentfrow and Gosling, 2003). Scheel and Westefeld (1999) investigated the relationship between a preference for heavy-metal music and vulnerability to suicide among 121 tenth- and twelfth-grade high-school students. Participants completed a questionnaire relating to reasons for living, risk of suicide and musical preferences. Heavy-metal fans had less strong reasons for living, especially male fans, and had more thoughts of suicide, especially female fans. For most, listening to all types of music had a positive effect on mood. While preference for heavy-metal music among adolescents may be an indication of increased suicidal vulnerability, the research suggested that the source of the problem was more likely to lie in personal and familial characteristics than in any direct effects of the music. However, group music therapy can support young people at risk of mental health problems and can reduce unhealthy uses of music (Gold et al., 2017).

Saarikallio and Erkkilä (2007), in a large study of 1515 participants with an average age of 15 years old, found that the most preferred musical styles for boys and girls across all age groups were rock, pop, heavy metal and rap. Boys preferred heavy metal and techno music, whereas girls preferred classical music, pop and gospel. Preferences for classical, rock, jazz, folk and gospel music increased with age, while the preference for pop music gradually decreased. Eclectic musical preferences were related to the extent of the use of music to regulate moods. Overall, Saarikallio and Erkkilä demonstrated how personal factors were linked to differences in adolescents’ use of music. Those preferring rock and heavy-metal music made greater use of music to regulate their moods. Perhaps the intensity, volume and roughness of these genres reflects the intense emotional experiences which are characteristic of adolescence. In contrast, listening to pop, rap and techno music tended to create positive, feel-good experiences

For many years now it has been possible to use a range of devices to listen to music anywhere and at any time. Skånland (2011; 2013) researching the use of the MP3 player suggested that such availability could be valuable in supporting listeners in coping with crowded and noisy environments, and promoting wellbeing and mental health. Further developments in music technology have meant that people can find expression through creating playlists. These can support the maintenance of mood and recall of memories (Bull, 2005), while Hagen (2015) observing students’ use of the playlist function concluded that playlists based on moods, feelings, memories, or biographical, relational representations helped users experience mastery over themselves. Playlists may also support social cohesion as some of the pleasure of creating them may come from owning, customising and trading them (McCourt, 2005).

There are differences in the extent to which listeners are aware of how music affects them. More engaged listeners are acutely aware of how music can change or fit their moods (Greasley and Lamont, 2011). Squirrel listeners (Lamont and Webb, 2010) are better able to access and implement strategies to regulate their moods choosing music to fit any given situation and their own physical, psychological and social needs. Batt-Rawden and DeNora (2005) describe this as ‘lay therapeutic practice’.

Singing

One strand of research examining the relationship between wellbeing and music has focused on singing. Reviews of the research on participation in choirs have identified many benefits, including:

physical relaxation and release of physical tension;
emotional release and reduction of feelings of stress;
a sense of happiness, positive mood, joy, elation and feeling high;
a sense of greater personal, emotional and physical wellbeing;
an increased sense of arousal and energy;
stimulation of cognitive capacities, attention, concentration, memory and learning;
an increased sense of self-confidence and self-esteem;
a sense of therapeutic benefit in relation to long-standing psychological and social problems;
a sense of exercising systems of the body through the physical exertion involved, especially the lungs;
a sense of disciplining of the skeletal-muscular system through the adoption of good posture;
being engaged in a valued, meaningful worthwhile activity that gives a sense of purpose and motivation (Clift et al., 2008; Clift, 2012; Stacey et al., 2002).

Group singing has been found to reduce anxiety and depression (Houston et al., 1998; Lally, 2009; Wise et al., 1992; Zanini and Leao, 2006), as well as providing opportunities for developing social networks. Singing has a variety of positive effects on both mental and physical health (Fancourt et al., 2019; Irons et al., 2020; Kreutz et al., 2004; Moss and O’Donoghue, 2020).

Kreutz (2014) studied the psychobiological effects of amateur choral singing with a mixed group of 21 novice and experienced singers who completed questionnaires about their psychological wellbeing and gave samples of saliva for measuring levels of salivary oxytocin, cortisol and dehydroepiandrosterone at the beginning of two rehearsal sessions and 30 minutes later. The singing condition included warm-up vocal exercises and repertoire pieces. In a control condition, dyads of participants talked to each other about recent positive life experiences. The findings showed patterns of change favouring singing over chatting. There were no significant interactions for cortisol, dehydroepiandrosterone or the cortisol dehydroepiandrosterone ratio. Overall, the findings suggested that singing enhances individual psychological wellbeing, as well as inducing a sociobiological bonding response.

Grape and colleagues (2003) also used a range of physical markers to explore the possible beneficial effects of singing on wellbeing during a singing lesson. Eight amateur singers aged 28 to 53 years old, and eight professional singers aged 26 to 49 years who had been attending singing lessons for at least six months, participated. Electrocardiogram measures were recorded and computerised spectral analysis was performed. Serum concentrations of TNF alpha, linked to autoimmune systems, prolactin, cortisol and oxytocin were measured before and 30 minutes after the lesson. Five visual scales—sad joyful, anxious calm, worried elated, listless energetic, and tense relaxed—were scored before and after the lesson alongside a semi-structured interview. Heart rate variability analyses showed significant changes over time in the two groups. Power increased during singing for the professionals, whereas there were no changes in the amateurs. This indicated an ability to retain more heart-brain connection, more cardiophysiological fitness for singing in professional singers, compared to amateur singers. Serum concentration of TNF alpha increased in professionals after the singing lesson, whereas the concentration in amateurs decreased. Serum concentrations of prolactin and cortisol increased after the lesson in the group of men and vice versa for women. Oxytocin concentrations increased significantly in both groups after the singing lesson. Amateurs reported increasing joy and elatedness, whereas professionals did not. However, both groups felt more energetic and relaxed. The interviews showed that the professionals were clearly achievement oriented, with a focus on singing technique, vocal apparatus and body during the lesson. In contrast, the amateurs used the singing lessons as a means of self-actualisation and self-expression, as a way to release emotional tensions. Overall, singing lessons seemed to promote wellbeing and reduce arousal for amateurs compared to professional singers, who seemed to experience the reverse.

In a study of young people who were members of a university choir, Clift and Hancox (2001) identified six elements associated with the benefits of singing: wellbeing and relaxation; enhanced breathing and posture; social benefits; spiritual benefits; emotional benefits; and benefits for the heart and immune system. In a later study, Clift and Hancox (2010) surveyed 1124 choral singers drawn from choirs in Australia, England and Germany. Participants completed a questionnaire which measured physical, psychological, social and environmental wellbeing, and a measure of the effects of choral singing. Open questions provided more in-depth understanding. There was a high level of agreement about the positive benefits of choral singing, with women significantly more likely to endorse its value for wellbeing and health compared with men. There was a small significant relationship between psychological wellbeing and the effects of choral singing for women, but not for men. Eighty-five participants with relatively low psychological wellbeing had high scores on the singing scale. Four categories of significant personal and health challenges were disclosed by members of this group: enduring mental health problems; family and relationship problems; physical health challenges and recent bereavement. Their accounts suggested six ways that singing might impact on wellbeing and health: positive affect; focused attention; deep breathing; social support; cognitive stimulation and regular commitment. In a further study Clift and colleagues (2017) studied four community singing groups which met weekly for people with mental health issues. Evaluation took place over a six-month period using two questionnaires. Twenty-six participants completed baseline and follow-up questionnaires. The findings showed that clinical scores reduced, and wellbeing scores increased significantly.

In a comparison of gender differences, Sandgren (2009) examined how emotional states varied on measurements pre- and post- a regular choral rehearsal in 212 participants from eleven choirs. Women reported significantly more positive emotional states than men relating to participation in regular choir rehearsals, although the differences were small. Men and women reported similar levels of negative emotions, but varied more in the extent of positive change after the choir rehearsal.

Some research has focused on the impact of participation in a choir on very specific groups of people. For instance, Bailey and Davidson (2002; 2003) studied whether positive life transformations could occur when homeless men joined a choir. Using semi-structured interviews they found that group singing positively influenced emotional, social and cognitive processes. They concluded that active participation in singing may alleviate depression, increase self-esteem, improve social interaction skills and induce cognitive stimulation. In a later study, Baily and Davidson (2005) explored the effects of group singing and performance with a second choir formed for homeless and other marginalised individuals who had little or no music training or group singing experience, and middle-class singers with low to high levels of music training and choral singing experience. The findings showed that the emotional effects of participation in group singing were similar regardless of training or socioeconomic status, but the interpersonal and cognitive components of the choral experience had different meanings for the two groups. The marginalised individuals appeared to embrace all aspects of the group singing experience, while the middle-class choir members were inhibited by social expectations of musicianship. Also working with a distinctive group, Southcott and Nethsinghe (2019) explored the understandings and meanings of shared music-making held by members of the Young Hearts Russian choir in Melbourne, Australia and its impact on their quality of life. The elderly participants were first-generation migrants who spoke most strongly in their first language, Russian. Individual semi-structured interviews were undertaken with nine choir members, while focus group discussion included all 28 members. The interviews revealed two broad themes: maintaining independence and resilience and learning, rehearsing and performing music. Sub-themes included the importance of participation, maintaining face, overcoming illness and disability, and becoming a family. Singing together enhanced quality of life, combatted social isolation, fostered resilience and sense of autonomy, and allowed participants to access inner resources to face life challenges.

Considering issues relating to a range of disabilities, Dingle and colleagues (2012) explored the personal experiences of choir members, 89 percent of whom experienced chronic mental health problems, 28 percent physical disabilities and 11 per cent intellectual disability. Semi-structured interviews were carried out with twenty-one members of the choir at three time points in the choir’s inaugural year, at the inception of the choir, after six months, and after twelve months. Three themes emerged:

personal impact in terms of positive emotions, emotional regulation, spiritual experience, self-perception, finding a voice;
social impact including connectedness within the choir, connection with audience, social functioning; and
functional outcomes including health benefits, employment capacity and routine.

Overall, forming a new and valued group identity as a choir member was associated with emotional and health benefits for participants. Fancourt and colleagues (2019) focused on those who were recently bereaved. Fifty-eight adults bereaved in the last five years who had not received treatment of any kind for anxiety or depression in the last month were recruited. Half participated in a choir or acted as a non-intervention control group. Those joining the choir were engaged in 90-minute weekly singing and social sessions for 12 weeks, with a post-intervention assessment after 24 weeks. Those who sang in a choir had more stable symptoms of depression and levels of wellbeing, as well as gradual improvements in their sense of self-efficacy and self-esteem. In contrast, those in the control group showed gradual increases in depressive symptoms, reductions in levels of wellbeing and self-esteem and no improvement in their self-efficacy.

It is not only singing that can have positive benefits for wellbeing. In a review, Perkins and colleagues (2020) identified 46 qualitative studies reporting on participants’ subjective views of how participatory music engagement supported their mental wellbeing. Thematic coding revealed four themes: managing and expressing emotions, facilitating self-development, providing respite and facilitating connections. The outcomes of choral singing have also been compared with listening to music. Boyd and colleagues (2020) examined the short-term effects on mood and self-esteem of a novel group singing model that relied exclusively on oral methods of teaching songs to 59 community-recruited adults and compared the effects with group listening. The findings showed that participants’ positive emotions and mood improved after singing but declined after listening. Self-esteem increased throughout the sessions regardless of the activity, indicating the importance of the social nature of the singing activities.

Wellbeing in Young Children

Much of the evidence relating to wellbeing in babies, infants and children has been set out in previous chapters. In infancy and early childhood, musical activity largely takes place through interactions with caregivers. Ruud (1997) suggests that the first musical memories often include feelings of being held by parents. Songs are frequently more important than speech in bonding (Nakata and Trehub, 2004; Shenfield et al., 2003). Cirelli and Trehub (2020a) examined the relative efficacy of parents’ speech, and singing familiar and unfamiliar songs, in alleviating the distress of 68 eight- and 68 ten-month-old infants. Parent-infant dyads participated in three trials of a still-face procedure, featuring a two-minute play phase, a still-face phase (where parents were immobile and unresponsive for one minute or until infants became visibly distressed), and a two-minute reunion phase in which caregivers attempted to reverse infant distress by singing a highly familiar song, an unfamiliar song, or talking expressively. In the reunion phase, talking led to increased negative affect in both age groups, in contrast to singing familiar or unfamiliar songs, which increased infant attention to parents and decreased negative affect. The favourable consequences were greatest for familiar songs, which also generated increased smiling. Skin conductance recorded from a subset of infants revealed that arousal levels were highest for the talking reunion, lowest for unfamiliar songs, and intermediate for familiar songs. The arousal effects, considered in conjunction with the behavioural effects, confirmed that songs were more effective than speech at mitigating infant distress.

Krueger (2011) argued that, from birth, music is perceived as a structure that offers the possibility of constructing and regulating emotions, expressing and communicating, and shaping relationships and situations. In children’s play, symbols, drawings and music can be used thoughtfully but activities are mainly participatory, engaged and active (Bonsdorff, 2017; Karlsen, 2011; Kuuse, 2018). From an early age, using these resources, children develop a sense of agency and self-efficacy. Informal learning of music is frequent in everyday life (Batt-Rawden and DeNora, 2005). This creates memories, patterns, meanings and opportunities for interaction between individuals and their social surroundings. Learning how music can be used empowers the individual to act on their own moods and emotions, wellbeing, health and agency (DeNora, 2000; 2001; Skånland, 2013). Musicality has been argued to be intrinsic to communication between parents and infants (Malloch and Tervarthen, 2009). Parents use music to support other activities and to create a calm and soothing environment prior to sleep times, in addition to participating in child-centred musical activities (Lamont, 2008). Child-parent interactions can be enhanced by music therapy, as can impulse control and self-regulation skills (Pasiali, 2012) and social and communication skills (Mackenzie and Hamlett, 2005; Nicholson et al., 2010; Walworth, 2009). For instance, de Gratzer (1999) showed in a ten-month action research project of group music-making between parents and toddlers that non-verbal communication between parent and child was enhanced. Williams and colleagues (2012) examined the effectiveness of a short-term group music therapy intervention for 201 parents of children with disabilities and found that there were significant improvements for parental mental health, child communication and social skills, parenting sensitivity, parental engagement with and acceptance of their child, child responsiveness to parent, and child interest and participation in programme activities.

As we saw in Chapter 13, moving in time together promotes social bonding. This is important for the social development of infants, as it promotes positive interactions with caregivers. Young infants seem to enjoy listening to and moving to music. For instance, Cirelli and Trehub (2020b) studied an infant who began moving rhythmically to music at six months of age. Across nine sessions, beginning when she was almost 19 months of age and ending eight weeks later, she was video-recorded by her mother during the presentation of 60-second excerpts from two familiar and two unfamiliar songs presented at three tempos: the original tempo and faster and slower versions. The child exhibited a number of repeated dance movements such as head-bobbing, arm-pumping, torso twists and bouncing. She danced most to Metallica’s ‘Now that We’re Dead’, a recording that her father played daily in her presence, often dancing with her while it played. Its high pulse clarity, in conjunction with familiarity, may have increased her propensity to dance, as reflected in lesser dancing to familiar music with low pulse clarity and to unfamiliar music with high pulse clarity. She moved faster to faster music but only for unfamiliar music, perhaps because arousal drove her movement to familiar music. Her movement to music was positively correlated with smiling, highlighting the pleasurable nature of the experience. Rhythmic movement to music may have enhanced her pleasure, although the joy of listening may have promoted her movement.

More formal engagement with music may begin in early years education. Certainly, early years educators have positive attitudes towards music and value it, even if they have no formal qualifications in music (Barrett et al., 2019). Parents, grandparents and former child participants of early learning music programmes acknowledge that such programmes enhance musical knowledge and skills (Barrett and Welch, 2020). Active group music-making also enhances pro-social behaviour in young children. For instance, Kirschner and Tomasello (2009; 2010) studied four-year-olds in tasks requiring identical skills in musical and non-musical conditions. Joint music-making enhanced cooperation and helpful behaviour.

Music and Wellbeing in School-Aged Participants

Previous chapters have shown that active engagement with music can enhance intellectual functioning, spatial reasoning, mathematical performance, phonological awareness, literacy, educational attainment and personal, social and physical development. The extent to which these benefits are realised depends on a wide range of factors, not least the nature and quality of the musical education experienced, and the level of commitment and engagement of the child. As musical skills are acquired, a greater sense of purpose and self-confidence can develop (Creech et al., 2013; 2016; Hallam et al., 2017). In this way, music education can have an impact on wellbeing. For instance, Lage-Gómez and Cremades-Andreu (2019) presented the results of a collaborative action research study in Spanish secondary education. Data collected included observations, interviews, classroom diaries, assessments, questionnaires, and video and audio recordings. The findings showed how group improvisation was influenced by:

active student involvement and wellbeing;
the students’ identification with the music;
the emergence of group flow and positive emotions, including a high level of motivation; and
the musical experiences from the students’ roles as musicians.

Similarly, informal learning in small groups in the music classroom can benefit wellbeing, leading to enhanced self-esteem, positive relationships, competence and optimism (Hallam et al., 2016; 2017; 2018). Overall, group music-making supports children in improving their social and communication skills, cooperation and teamwork (Creech et al., 2013; 2016).

One strand of research has focused on children perceived as ‘at risk’. The El Sistema programme and projects inspired by it—where children experience intensive and prolonged engagement in an orchestral community—facilitate pro-social behaviour, and the psychological and physical wellbeing of their students. Evaluations of individual programmes report strengthening children’s sense of individual and group identity, causing children to take pride in their accomplishments, enhancing determination and persistence, and making children better able to cope with anger and express their emotions effectively. Children value their participation as a social activity, a way to enjoy music with others, to strengthen friendships with peers, work in teams and acquire musical skills (Creech et al., 2013; 2016).

Some research has focused on children who are marginalised or at risk. For instance, Cain and colleagues (2016) carried out a review of the impact of participatory music programmes, which aimed to promote positive mental and physical health, and wellbeing outcomes for young people from culturally and linguistically diverse communities. The majority of music participation programmes targeted toward young people characterised as ‘at risk’ have had positive outcomes, including a reduction in anxiety, depression, emotional alienation, truancy and aggression. Participants showed an increase in attendance at school, enhanced self-esteem, cultural empathy, confidence, personal empowerment and healthier nutrition. Similarly, Brown and colleagues (2017) investigated the influence of the arts on cortisol levels in economically disadvantaged children. Three hundred and ten children, aged three to five years old, who attended a Head Start preschool were randomly assigned to participate in different schedules of arts and homeroom classes on different days of the week. Cortisol was sampled at morning baseline and after arts and homeroom classes on two different days at the start, middle and end of the year. For music, dance and visual arts, grouped and separately, the findings showed that cortisol was lower after an arts versus homeroom class at the middle and end of the year, but not at the start of the year. A similar project, where professional musicians worked with school-aged children (Ward et al., 2020) showed through interviews with teachers, musicians, parents and observations that pupils experiencing socioeconomic deprivation enjoyed the benefits of fellowship through group-based music activities. Previously shy pupils began to contribute more in class, and anxious children overcame their fear of performing on stage. Teachers commented that the project had developed pupils’ self-confidence.

One strand of research has focused on children’s wellbeing in terms of the role that music can play in improving overt behaviour. For instance, Fasano and colleagues (2020) explored whether short orchestral music training could reduce impulsive behaviour. One hundred and thirteen Italian children aged eight to ten years of age participated. Fifty-five attended three months of orchestral training, which included a two-hour lesson each week at school and a final concert. The 58 children in the control group had no orchestral training. The children were assessed in relation to inhibitory control and hyperactivity at the beginning and end of the three-month training period. Children in the music group showed a significant improvement in inhibitory control, while the control group showed an increase in self-reported hyperactivity. This suggests that even an intense and brief period of orchestral training can facilitate the development of inhibitory control by modulating levels of self-reported hyperactivity. Large-scale community-based music programmes for children exposed to violence have also been found to improve self-control and reduce behavioural difficulties. For instance, Alemán and colleagues (2017) assessed the effects of an El Sistema music programme on children’s developmental functioning in the context of high rates of exposure to violence. The programme emphasised social interactions through group instruction and performance. The research was conducted in 16 music centres and included 2914 children aged six to fourteen years old. Half were admitted to the programme earlier than the remainder. Data collected at the end of the programme indicated improved self-control and reduced behavioural problems. This was particularly the case for children with less educated mothers, and for boys, especially those exposed to violence. Overall, the programme improved self-control and reduced behavioural difficulties.

English and colleagues (2021) explored the viability and effects of a six-week digitally based music outreach programme using GarageBand for children in a small rural town who were experiencing difficulties in the upper-primary- and lower-secondary-school years. Focus groups, observations and daily notes showed a significant positive impact on the teachers and children involved. Similarly, Chao-Fernández and colleagues (2020) analysed the benefits of music therapy for six students with disruptive behaviours. A series of activities were designed based on the use of the music video game Musichao. There were significant improvements in the development of self-motivation, self-awareness, self-control and social skills. Ye and colleagues (2021) undertook a meta-analysis including ten studies on the effect of music-based interventions on aggressive behaviour in children and adolescents. There was a significant decrease in aggressive behaviour and a significant increase in self-control in the music-based intervention group compared with the control group.

Some research has focused on children experiencing internalised problems. In South Korea, Kim (2017) investigated the effects of community-based group music therapy in children aged seven to twelve who were exposed to ongoing child maltreatment and poverty. Fourteen children experienced music therapy, while twelve acted as controls. Those in the music therapy group received twelve consecutive group music therapy sessions once a week, whereas the control children had no such opportunities. Teacher and child reports assessed behavioural change and showed that children in the music therapy group were less depressed, anxious and withdrawn, and had fewer attention problems than those acting as controls.

In New Zealand, since the 2010-2011 earthquakes, staff and learners at Waitakiri School have participated in daily singing specifically to promote wellbeing. Facilitation of the singing involved no pressure, but rather democratic and participatory conditions, with teachers avoiding judging learners’ progress and achievement, and a focus on being together and having fun. Although some teachers lacked confidence about leading singing and the focus was on having fun, learners still developed key competencies and learned musical concepts (Rickson and colleagues, 2018). In England, Chernaik (2021) reported the impact on wellbeing in primary-school children aged eight to ten years old who were exposed to live music provided by professional classical musicians over the period of a school year. The project began with six classroom workshops in each school, progressed to a chamber orchestra workshop for groups of three or four schools in a local venue, and culminated in a symphony orchestra concert. Questionnaires completed following the concerts showed that a range of positive emotions were experienced by the children including excitement, happiness, feeling calm, relaxed, impressed and amazed. Focusing exclusively on extracurricular group percussion activities, Burnard and Dragovic (2015) analysed data from 14 rehearsals, 13 semi-structured interviews and 41 teachers’ and pupils’ reflective diary entries. The findings showed the potential for such activities to enhance pupil wellbeing by empowering them and enhancing support and decision-making.

Croom (2015) reviewed studies on engagement with music within the PERMA framework to support the claim that music practice and participation could positively contribute to living a flourishing life through positively influencing emotions, engagement, relationships, meaning and accomplishment. Similarly, Lee and colleagues (2017) identified 17 case studies that described successful music programmes in schools in Australia. Content from these case studies was aligned with the five categories of the PERMA wellbeing model. The findings showed that the relationship element of the model was most frequently mentioned. Collaboration and partnership between students, teachers, staff in schools and local people in the community including parents, local entrepreneurs and musicians were repeatedly identified as a highly significant contributing factor to the success of music programmes. Overall, the findings indicated that tailored music and relationship-centred music programmes in schools not only increased the skills and abilities of the students, but also improved their psychosocial wellbeing and that of the community.

Music and Wellbeing in Adolescents and Young People

A great deal of research has been carried out with reference to music and adolescence. As we saw earlier, music plays an important role in teenagers’ lives (Bonneville-Roussy et al., 2013; Bosacki and O’Neill, 2013; Greasley and Lamont, 2011). Of all age groups, music seems to be most important for young people (Christenson et al., 1985; Christenson and Roberts, 1998; Gabrielsson and Lindström Wik, 2003; Roe, 1985; Zillmann and Gan, 1997). Music—as it is engaged with in leisure time—contributes to how an individual defines themselves (Hargreaves et al., 2002; Hense and McFerran, 2017; North and Hargreaves, 1999). It is seen to represent personality and is used in impression management, as well as to judge the characteristics of others (Krause and Hargreaves, 2013). In the digital world, this is achieved by controlling what music is shared with others and what is uploaded into personal collections (Voida et al., 2006). By engaging in social comparisons, adolescents are able to portray their own peer groups more positively than other groups in their network, and are thus able to sustain positive self-evaluations. Music facilitates this process (Tarrant et al., 2000). Tarrant and colleagues (2001) investigated English male adolescents aged 14 to 15 years old’s perceptions of in-group and out-group. Participants reported greater liking for the in-group and associated it more positively with stereotyped music compared with the out-group. The in-group was viewed as more fun, masculine and sporty and less boring, snobbish and weird. Participants with lower levels of self-esteem showed greater differentiation between groups and greater derogation of the out-group. Van Zalk and colleagues (2009) examined the role of similarity in music preferences in the formation and discontinuation of friendships over a one-year period. Questionnaire data were gathered from 283 Dutch same-sex mutual best friends of almost 13 years of age. The findings showed consistent evidence for high similarity in specific music dimensions among friends at the beginning and end of the year. Moderate similarity was found in the overall patterning of preferences for music genres at both points in time, even after controlling for similarity in social background. Specific music similarity in more non-mainstream music dimensions, and overall music similarity at the beginning were related to selecting a new friend at the end of the time period. However, similarity in music preferences was not related to the discontinuation of existing friendships. Similarity in music preferences seemed to be related to friendship formation but not discontinuation.

Music plays a role in developing and retaining a sense of agency (Saarikallio, 2019). Seeking and exploring a sense of agency through music is particularly relevant for young people but also for those experiencing a reduction in their ability to control their actions and/or their environment due to illness or challenging personal situations (Magee et al., 2017). Sense of agency is important for social-emotional health and can be supported through musical engagement (Saarikallio, 2017; 2019; Saarikallio and Baltazar, 2018). Evaluating the impact of a short music intervention with adolescents, McFerran and colleagues (2018) observed that sense of agency was key. After participation, young people reported an increased awareness of how they could utilise music to reduce distress and promote their own development. Similarly, Saarikallio and colleagues (2020) collected self-reports of personal music listening and their impact on agency from 44 adolescents with an average age of 14 who had received musical training. While there was no general increase in agency over time, there were fluctuations. These were determined by specific contextual factors: for instance, a change in environment, or changes in moods and reasons for listening to music. Elvers (2016; 2018) developed a framework which suggested that increases in feelings of power and control were related to enhanced self-esteem, which could be induced through musical experiences that promoted positive affect, empathy, pleasure and social cohesion. Similarly, music students’ wellbeing has been found to improve when their teachers adopt autonomy-supporting strategies (Bonneville-Roussy et al., 2020).

The emotional use of music may not differ according to the type of musical activity, since adolescents’ reasons for listening and playing have been shown to be quite similar to one another (North et al., 2000, Saarikallio and Erkkilä, 2007). In a study of 38 adolescents divided into two age groups—9 to 12 and 13 to 17, Tolfree and Hallam (2016) established that, of the four main themes emerging from the data, music in relation to emotions and moods was the strongest. Older girls used music to express anger, stating that it provided a means of acceptable rebelliousness when they were angry with their parents or others in their family. Playing an instrument was not used in relation to managing emotions. Indeed, for most people of any age, listening is the preferred activity for regulating moods, mainly because music is so readily available in the modern world. Lincoln (2005) explored the dynamic relationship between young people, bedroom space and music. Using the concept of zoning, she established that music was used by teenagers spontaneously to create particular atmospheres in their bedrooms, which depended on their age, mood, the time of day, other concurrent activities and other occupants of the space (for instance, friends or siblings). Music blurred the boundaries of public and private space. Music played at a high volume spilled out of the bedroom zone into other rooms in the house. Music was also used as a prequel and a sequel, facilitating getting ready for nights out, setting the right tone and atmosphere.

Teenagers report listening to music to pass time, alleviate boredom, relieve tension and distract themselves from worries. Music is seen as a source of support when they are feeling troubled or lonely, acting as a mood regulator, helping them to maintain a sense of belonging and community (Schwartz and Fouts, 2003; Zillman and Gan, 1997). Music fosters their ability to cope with the challenges that they face, including positive relationships with peers (Papinczak et al., 2015; Selfhout et al., 2009; Ter Bogt et al., 2017), managing emotions (McFerran and Saarikallio, 2014; Saarikallio and Erkkilä, 2007) and developing self-determination (Laiho, 2004). Some have suggested that it is because music plays an important part in these developments that it is so important in adolescents’ lives (Laiho 2004; Miranda, 2013; Schwartz and Fouts, 2003). Saarikallio (2019) argued that music is the adolescent’s world, their playground and kingdom. They express themselves through it, discover themselves and make their own choices. Studying young adults, Gupta and Kumar (2020) examined the effects of listening to instrumental music over a 20-day period and showed that music listening significantly increased resilience, self-efficacy, optimism, meaning in life and psychosocial flourishing. They concluded that music had the potential for generating positive schemas which could enhance wellbeing and serve as a buffer against increasing negativity in the modern world. Even quite young adolescents use music to manage their moods. For instance, Behne (1997) carried out a longitudinal study of 155 adolescents aged 11 to 17 years old and identified nine listening styles including compensating, concentrated, emotional, distancing, vegetative, sentimental, associative, stimulative and diffused. At ages 11 to 13, the most pronounced listening style was compensating, demonstrating that even young adolescents know how to use music for mood regulation. In general, different strategies for coping with emotions are acquired with age (Seiffge-Krenke, 1995; Mullis and Chapman, 2000).

In a series of studies, Saarikallio and colleagues (Saarikallio, 2006; Saarikallio and Erkkilä, 2007) developed a theoretical model consisting of seven regulatory strategies relating to music: entertainment, revival, strong sensation, diversion, discharge, mental work and solace. They surveyed 1515 adolescents, 652 boys and 820 girls, with an average age of 15. The strategies used most often by boys and girls in all age groups were the same: entertainment, revival and strong sensation. Overall, girls used music for mood regulation more than boys. The use of music for mood regulation increased with age for both sexes but the change occurred later for boys. Singing or playing an instrument as a hobby, valuing music and listening to it were positively related to using music to regulate mood. Composing songs also led to increased regulatory use of music, as did having a family member who sang or played an instrument. Listening alone was chosen by over half of the respondents in all age groups as an influencer of mood. The ways that music was used to regulate mood involved elements that adolescents were often not conscious of in their daily engagement with music (Saarikallio, 2006; Saarikallio and Erkkilä, 2007). Ongoing cognitive development and an increased ability for abstract comprehension may help older adolescents to be more conscious of how they use music to regulate mood. Saarikallio and colleagues (2017) studied 55 adolescents with an average age of 15 who listened to self-selected relaxation music for 20 minutes, once in a laboratory and once at home, and provided written descriptions of their experience. Three major strategies—processing, distraction and induction—and two mechanisms (musical and mental) were identified. Processing was supported by both mechanisms, while distraction and induction were supported predominantly by music. Change from negative to positive mood was generally realised through musical distraction, while the induction of positive emotion was supported by all strategies and mechanisms. In a later study, Baltazar and Saarikallio (2019) studied 571 participants and identified six contrasting strategic uses of music: cognitive work, entertainment, affective work, distraction, revival and focus on the situation. Clear associations between strategies and mechanisms emerged, laying the foundations for a model that integrated regulatory strategies and mechanisms as intrinsic and interrelated components of behaviour (Baltazar, 2019). In an experimental study, Baltazar and colleagues (2019) manipulated the benefits of music and strategy use in reducing stress. Overall, music had a greater impact on short-term outcomes of self-regulation in comparison to strategy use, suggesting that successful affective regulation depends on the adequacy of the chosen strategies and the music, but that the music itself is key in the short term.

An increasing body of research has indicated that listening to music can have very different purposes and outcomes. For instance, McFerran and colleagues (2014) reported an investigation examining how 111 Australian adolescents reported perceived changes in their mood before and after listening to self-selected music. Most reported using music to improve their mood, particularly when their initial state was already positive. However, when feeling sad or stressed, some reported a worsening mood. Those young people who were distressed tended to prefer listening to heavy-metal music but did not report more negative effects on mood for this than for any other genre. They concluded that interpreting such findings was complex, and overly simplistic interpretations needed to be avoided. Miranda (2013; 2019), in two reviews, proposed that music could be both a protective factor and a risk factor in relation to coping in adolescence. McFerran and Saarikallio (2014) explored with 40 Australians aged 13 to 20 years old the beliefs that they held about the power of music to support them during challenging times. They were asked to recall times when music had supported them and times when it had been unhelpful. They considered why young people’s beliefs about the positive consequences of music were so strong, even though for those with mental health problems this was not always the case. Miranda and Gaudreau (2011) considered emotional reactions following listening to music, depending on different levels of emotional wellbeing, and also the relationships between social congruence in music tastes with friends or parents and emotional wellbeing. Three hundred and sixteen adolescents with a mean age of 15 years old participated. Three profiles were identified: emotionally negative, limited or positive listeners. These were related to emotional wellbeing, as was social congruence in musical tastes with friends and parents. Also exploring differences between individuals, Gibson and colleagues (2000) divided high-school students into high and low loneliness groups in relation to romantic deprivation, and rated their enjoyment of love-lamenting and love-celebrating videos of popular romantic music. Loneliness proved inconsequential for the enjoyment of love-lamenting songs, although highly lonely males enjoyed love-celebrating songs markedly less than less lonely males. In contrast, highly lonely females enjoyed love-celebrating songs more than less lonely females.

Not all the effects of listening to music are positive. Adolescents may use music as a distraction to avoid thinking about problems (Saarikallio and Erkkilä, 2007). This can have a negative impact on their psychological adjustment (Hutchinson et al., 2006). Listening to music which explores negative themes—for instance, distress, suicide or death—can increase depressive symptoms and suicidal thoughts (Martin et al., 1993; Scheel and Westefeld, 1999). These negative outcomes can be exacerbated through interactions with like-minded peers through music subcultures. For instance, Stewart and colleagues (2020) studied seven Australian young people with a tendency towards depression, exploring their listening habits and their level of awareness of the impact of their music-listening on mood and wellbeing. The findings showed that, while music can have a positive effect on mood, it can also intensify negative moods. They suggested that the relationship between intentions and outcomes is mediated by differing levels of self-awareness and insight into the mood regulation processes which occur during listening to music. Some musical subcultures, such as goth or emo, are focused on music with dark and depressing themes. The blame for some suicides has been laid at the door of such music (Young et al., 2014). In Australia, music therapy carried out over eight weeks was compared with self-directed music-listening in a group of 100 students with self-reported unhealthy music use. There were no differences in outcomes. Both groups showed small improvements over time, although younger participants benefited more from the therapy, and older participants from self-directed listening (Gold et al., 2017).

Specific aspects of music listening can impact on wellbeing. In a small-scale study, Papinczak and colleagues (2015) analysed transcripts from focus groups with 11 participants aged 15 to 25 years old. Four ways in which listening to music linked with wellbeing were revealed: relationship-building, modifying emotions, modifying cognition and emotional immersion. A follow-up questionnaire study with 107 young people showed that music-listening was significantly related to each of these but not directly related to wellbeing. Ter Bogt and colleagues (2017) studied whether adolescents and young adults used music as an agent of consolation when dealing with sorrow and stress, and whether the music itself, its lyrics or experiences of closeness to artists and fans were experienced as comforting. Overall, 1,040 respondents (aged 13 to 30 years old) responded to items assessing listening hours, the importance of music, music preferences, positive and negative effects elicited by music, internalised and externalised problems, and consolation through music. Slightly over 69 percent of respondents reported that they used music as a source of consolation, particularly females and those with higher levels of anxiety and depression. Music’s consoling effects were reported as resulting mainly from the sound and texture of the music itself, from attribution of personal meaning to the lyrics, and to a lesser extent from perceptions of closeness to artists and other listeners.

Young people in the Western world spend a great deal of their time listening to music but there is less research globally. Miranda and colleagues (2015), focusing on cultural differences, argued that music can be meaningful in similar and different ways for adolescents living in diverse sociocultural contexts, in which local and global cultures mix and hybridise (Larson et al., 2009). Boer and colleagues (Boer and Fischer, 2012; Boer et al., 2012) proposed two overarching dimensions of music: a contemplative or affective dimension, an individual dimension, and an intrapersonal, interpersonal, a social dimension (collectivism). Adolescents in more collectivist societies used music to convey cultural identity more than those in individualistic societies. Research in six countries (Germany, Kenya, Mexico, New Zealand, the Philippines and Turkey) revealed ten functions of listening to music in late adolescence: as background, focused listening, for venting, related to emotions, for dancing, related to friendship, family, politics, values and cultural identity (Boer et al., 2012). Research in seven countries revealed seven functions: music in the background, memories through music, music as diversion, emotional experiences from music, self-regulation through music, music as a reflection of the self and social bonding (Boer and Fischer, 2012).

Actively Making Music

In addition to listening to music, actively making music can impact on the wellbeing of young people. For instance, in the Netherlands, Uhlig and colleagues (2018) worked with 139 adolescents in schools and showed that engaging in rap and singing music therapy six times a week for four months led to enhanced psychological wellbeing, self-esteem and emotion regulation. Evaluating a similar rap and sing music therapy with 52 adolescents, Uhlig and colleagues (2019) showed a range of benefits for sleep compared with a control group. In the North East of England, Mogro-Wilson and Tredinnick (2020) evaluated the use of visual arts and music on 340 teenagers in a programme designed to enhance social and emotional skill-building. The programme was successful in meeting its aims, and demonstrated that art and music could become a powerful presence in the lives of young people.

Underlying the complexity of the relationship between music and wellbeing, Leung and Cheung (2020) used a process-oriented approach to establish the association between listening to music, playing a musical instrument, musical training and adolescents’ wellbeing. One thousand, three hundred and eighteen Chinese adolescents between 12 to 15 years of age from secondary schools in Hong Kong completed questionnaires. Awareness of emotions and emotions themselves were found to mediate between musical training and wellbeing. Positive and negative emotions also mediated between listening to music and wellbeing, although playing an instrument was not associated with emotional awareness, positive or negative emotions, or wellbeing. The findings further reinforce the problems of making direct links between music and wellbeing. Similarly, Clarke and Basillo (2018) investigated the role of the performing arts in 275 secondary-school pupils and demonstrated that the opportunities for playfulness and developing interpersonal relationships afforded by the activities predicted students’ wellbeing. The importance of musical context in impacting on wellbeing emerged from research by Baker and colleagues (2018), who studied an artist-led group song-writing programme with 85 young people. They found that contextual factors helped shape the song-writing environment. The young people felt safe, had fun and pushed boundaries, and there was direct and honest feedback, high energy rituals and an emphasis on artistic excellence. Anthony and colleagues (2018), studying the implementation of a music education programme with young people in remote Aboriginal communities, found that the informal learning frameworks (which incorporated music-making shared between educators and community members) provided constructive ways of engaging young people and empowering them in the management of their health and wellbeing. Similarly, in research in Nigeria, Ojukwu (2017) suggested that active engagement in music could promote positive youth development.

Working with at-risk students, Van Rooyen and dos Santos (2020) studied the experiences of teenagers in a children’s home who participated in a choir in South Africa. Sixteen weekly choir sessions were held, which included a variety of interactive vocal techniques. A performance marked the end of the process, where songs selected by the teenagers were performed. Qualitative data were collected through 14 semi-structured individual interviews at the end of the process. The findings showed that participation in the choir offered teenagers meaningful intra- and interpersonal experiences. At an intrapersonal level, participants discovered their musical voices, increased their self-awareness, self-esteem and self-confidence, and were able to express and regulate emotions. In terms of interpersonal experiences, the teenagers experienced growth in relationships, improved social skills and greater connection with the broader community. Also working with at-risk young people, Wilson and MacDonald (2020) reported on a ten-week group music programme for young Scottish adults with learning difficulties. Participants enjoyed the programme and participation was generally maintained, with benefits evidenced in increased social engagement, interaction and communication. As we saw in Chapter 12, young people who are disaffected can be re-engaged with their education through music. It can also enhance wellbeing in looked-after children and those in the criminal justice system.

One strand of research has focused on young people presenting issues with academic work. For instance, Sharma and Jagdev (2012) studied 30 adolescents with low self-esteem and high academic stress who engaged with music therapy for a period of 15 days. This reduced anxiety and enhanced self-esteem. Similarly, Schiltz (2016) studied 93 highly gifted adolescents suffering from school failure. They engaged with an integrated form of musical and verbal psychotherapy, musical improvisation with story-writing or the production of drawings with music, followed by verbal elaboration. Participants showed a significant increase in concentration, the capacity for imaginary and symbolic elaboration, pictorial and literary creativity, self-esteem and the quality of coping strategies. There was a significant decrease in defensive functioning and in embitterment and resignation. Music therapy can clearly be beneficial in these circumstances.

Some research has focused on extracurricular school activities. For instance, participating in a school production has been shown to promote friendship groups and support musical, personal and social development (Pitts, 2007; 2008). Kinnunen and colleagues (2020) focused on the social sustainability of music events in adolescents’ lives, through their perceptions and own words as they described live music experiences. A web survey of over 1000 adolescents aged 15 to 18 years old demonstrated that cultural content per se was not as meaningful to them as the social networks at such events. Bonding and bridging, as well as the sense of community, produced a range of benefits to wellbeing. Similarly, a thematic analysis by Caleon (2019), including 13 studies aimed at fostering wellbeing in adolescents, identified that music-based activities acted as catalysts for relationship-building, as a means of self-expression and self-regulation, and as a resource for self-transformation. Considering a heritage and related music project, Clennon and Boehm (2014) examined how creative activities that were embedded in a community could serve to enhance the cohesion and wellbeing of the community through the work of its youth groups. In a review, Zarobe and Bungay (2017) concluded that participating in arts activities could have a positive effect on wellbeing through enhancing self-confidence, self-esteem, relationship-building and a sense of belonging.

Music and Wellbeing in Adults

For most people, adulthood is characterised by relative stability and an increase in independence and responsibility, although there are transitions in relation to choices concerning work and family (Levinson, 1986; Levinson et al., 1978). Ageing and retirement bring new challenges, including acceptance of the decline in physical and psychological abilities and the loss of loved ones, while attempting to maintain control over life and sustain interest and motivation (Atchley, 1975; Erikson, 1982). In general, older people report fewer negative emotional experiences (Gross et al., 1997) and retain the ability to regulate their emotions, alongside a desire to derive emotional meaning from their lives (Carstensen et al., 2003). In relation to music, Sloboda and colleagues (2009) have shown that most of music’s functions in the everyday lives of adults are related to memories, moods and emotions. Similarly, Greasley and Lamont (2006) reported that adults’ use of music included a stress on personal choices, using music for emotional self-regulation and reflection on internal experiences and memories, while Van Goethem (2010) showed that the emotions most typically regulated through music were happiness and calmness. Saarikallio (2011) undertook a qualitative study with 21 participants aged 21 to 70 years old, and revealed that various regulatory goals and strategies were similar throughout adulthood, but that there were also changes related to age, particular events and retirement transition. All participants used music to generate and maintain happy moods, for pleasure and enjoyment. Moods were enhanced by listening to loud music, singing along, starting to play an instrument or even dancing. In addition to using music as a leisure activity, it was used to accompany all kinds of activities, to relax after a working day but also energise to prepare for an activity. When individuals are actively engaged with making music, its effects are greater (Greasley and Lamont, 2006). In adult life, there are many competing demands which affect participation and continuation with music-making. Personal determination and circumstances are key to understanding this (Pitts and Robinson, (2016).

In a very large-scale study in Sweden, Bygren and colleagues (1996) studied 15,198 individuals aged 16 to 74 years old. Of these, 85 percent were interviewed by trained non-medical interviewers about their cultural activities. Eight confounding variables—age, sex, education level, income, long-term disease, social networks, smoking and physical exercise—were controlled for. These influenced survival in the expected direction, except for social networks for men. Taking these into account, the research revealed an influence on mortality in people who rarely attended events compared with those attending most frequently. In another large-scale population study, Cuypers and colleagues (2011) analysed the association between cultural activity and perceived health, anxiety, depression and life satisfaction based on data from the third Nord-Trøndelag Health Study, which included 50,797 adult participants. The findings showed that participation in receptive and creative cultural activities was significantly associated with good health, positive satisfaction with life, and low anxiety and depression scores, especially in men attending the receptive, rather than creative, cultural activities. Similarly, Węziak-Białowolska and Białowolski (2016) investigated the causative impact of attendance at cultural events on self-reported and physical health in the Polish population. Four waves of the biennial longitudinal Polish household panel study representative of the Polish population aged over 16 were used. The findings confirmed that there was a positive association between cultural attendance and self-reported health, although it was not possible to establish a causal link. In another large-scale study, Weinberg and Joseph (2017) explored the connection between habitual music engagement and subjective wellbeing. Data were gathered as part of the 31st survey of the Australian Unity Wellbeing Index, to provide insight into the relationship between music engagement and wellbeing. A sample of 1000 participants were interviewed by telephone. The findings revealed that engaging with music by dancing or attending musical events was associated with higher wellbeing in comparison to those who did not engage with music. The findings also emphasised the importance of engaging with music in the company of others with regard to wellbeing, thus highlighting the interpersonal features of music-making.

In the UK, Tymoszuk and colleagues (2021) explored trends in participatory and receptive engagement with a broad range of arts in 5,338 adults. Over 97 percent of respondents reported engagement in arts activities during 2018 and 2019, with reading and listening to music being the most popular activities. Arts engagement was grouped into three distinct clusters. Almost 20 percent constituted low engagers whose main source of engagement was occasional reading; 44 percent constituted receptive consumers who read and listened to music frequently and engaged with popular receptive arts activities such as going to the cinema, live music, theatre, exhibitions and museums; while almost 36 percent constituted cultural omnivores who frequently engaged in almost all arts activities. Greater engagement with the arts was associated with higher levels of wellbeing, social connectedness and a lower possibility of intense social loneliness, although there was a positive association between greater arts engagement, depression and intense emotional loneliness in the most highly engaged omnivores.

Participation in Musical Activities

Pitts (2005) found that musical participation was a potential source of confirmation and confidence, providing opportunities to demonstrate existing skills and acquire new ones. Music can also give a structure to life and offer opportunities to perform with others, develop friendships, engage in social interaction, get relief from family and work pressures and provide spiritual fulfilment and pleasure. It can promote prosocial behaviour, leading to feelings of belonging, social adjustment, trust and cooperation (Anshel and Kipper, 1988; Odena, 2010). People from a range of different backgrounds can experience benefits to their emotional and physical wellbeing from making music, developing an increased sense of self-worth, enhanced social skills and wider social networks (Judd and Pooley, 2014). Lamont and Ranaweera (2020) compared happiness and wellbeing in adults involved in knitting or making music. Eight hundred and thirty-five amateur knitters and 122 amateur musicians completed a measure of happiness and questions about past and current involvement. The knitters scored significantly higher on happiness than the musicians, although no differences were found in relation to subjective wellbeing. Older participants scored more highly on all wellbeing measures, with no effect of time participating in the activity. Despite differences between the activities, participants experienced broadly similar physical, psychological and social benefits. In Australia, Krause and colleagues (2020 administered a questionnaire to 192 residents aged 17 to 85 years old who were participating in a musical activity at the time. The importance of music in individual’s lives was positively related to perceived wellbeing including competency, relatedness, autonomous motivation and the social, cognitive and esteem dimensions of wellbeing. These findings were particularly strong for female participants. Overall, there were positive associations between musical activity and psychosocial wellbeing.

As we saw in earlier chapters, positive outcomes have been reported from music interventions with adult offenders (Eastburn, 2003; Digard et al., 2007; Henley et al., 2012). In these studies, participants enhanced their communication and social skills, increased their confidence, were better able to reflect on their situation, and believed that they could change and attain their goals. Overall, their wellbeing was enhanced.

While there can be benefits to participating in music, it can also be stressful. Pitts (2020) studied membership of leisure-time music groups through an online survey of 559 participants in such groups. While there were many benefits to wellbeing through being a member of such groups, there were pressures for some groups as they struggled to maintain their survival in the face of dwindling membership and lack of funding. There can also be a negative impact on wellbeing for those for whom music is a career or potential career. For instance, 126 college students and amateur musicians in a joint Swiss-UK study were assessed in relation to their wellbeing, quality of life and general health (Philippe et al., 2019). Scores were high on general measures of quality of life for both groups and on environment, social relationships, physical health and psychological health. Differences between groups of musicians emerged in terms of overall quality of life and general health, as well as the physical health dimension, where college music students scored lower than the amateur musicians, although the college music students scored higher than the amateurs on social relationships. While music-making can offer some health-protective effects, this may not be the case among those aspiring to become professional musicians. Similarly, MacRitchie and Garrido (2019) studied professional and amateur orchestral musicians using questionnaires and interviews, and found that intellectual stimulation was high for these groups and that there was a balance between perceived challenge, effort and reward of the musical tasks. Emotional engagement increased with age for amateur players but decreased for professionals. Overall, social engagement was high, with players reporting feeling connected as a group whilst making music.

Some research has considered flow experiences in musical participation and their relationship with wellbeing. For instance, Baker and MacDonald (2013) studied flow in non-music-major university students and retirees and their sense of self, achievement, identity, satisfaction and ownership during the creation of personally meaningful songs. There were strong experiences of flow during song-creation when compared with sporting activities, dancing, yoga and performing music. Habe and colleagues (2020) studied 452 elite musicians and top athletes in their early twenties and found that flow was more often experienced in group than individual performance settings, and that life satisfaction was positively related to flow, particularly the challenge-versus-skill balance.

Attendance at Music Festivals

Music festivals offer unique opportunities for engagement with music. The excitement of physical proximity to the performers, social interaction with other attendees and the music itself all contribute to the experience (Oakes, 2003; Paleo and Wijnberg, 2006; Pitts, 2005). Engagement with music in a festival context can contribute to the creation of a sense of community, as it provides opportunities to engage in social activities (Frith, 1996; Gibson and Connell, 2005). It also contributes to the development of identity (Karlsen and Brändström, 2008; Matheson, 2005), although there can be negative outcomes and risks relating to the use of alcohol or drugs, overcrowding, mob behaviour and other public health issues (Earl et al., 2004). Pitts (2005) investigated audience experiences at a chamber music festival, and showed that social and musical enjoyment interacted to generate commitment and a sense of involvement in the event. Similarly, Burland and Pitts (2010) studied the roles that music played in the lives of jazz audiences at the Edinburgh festival. Analysis of a large-scale survey and in-depth interviews revealed a sense of community and atmosphere, within which audience members valued the opportunity to be amongst like-minded jazz enthusiasts.

Similarly, Pitts and Burland (2013) drew on evidence from nearly 800 jazz listeners, surveyed at the Edinburgh Jazz and Blues Festival and in the Spin jazz club, Oxford. Questionnaires, diaries and interviews were used to understand the experiences of listening for a wide range of audience members. The findings illustrated how listening to live jazz had a strongly social element, whereby listeners derived pleasure from attending with others or meeting like-minded enthusiasts in the audience, and welcomed opportunities for conversation and relaxation within venues that helped to facilitate this. Within this social context, live listening was (for some audience members) an intense, sometimes draining experience, while for others it offered a source of relaxation and absorption, through the opportunity to focus on good playing and preferred repertoire. Overall, live listening constituted an individual and social act which varied between listeners, venues and occasions. Packer and Ballantyne (2010) established that a sense of connection between participants and a separation from everyday life distinguished festivals from other musical experiences, providing a sense of disconnection that prompted festival attendees to reflect on their lives and their understanding of themselves. They reported benefits in terms of enhanced interpersonal relationships, a greater sense of belonging, being valued, a deeper understanding of self and emotions, enhanced self-perceptions, confidence, mastery, purpose in life, a greater sense of agency, better strategies for coping with stress, a sense of making a contribution, and being more hopeful. These benefits reflect those reported by those engaged in making music.

Strong experiences of music most commonly occur in live settings (Gabrielsson, 2011; Lamont, 2011). Experiences are enhanced if the performers appear to be enjoying the experience and if they interact with the audience (Brand et al., 2012; Pitts and Burland, 2013; Pitts and Spencer, 2008; Radbourne et al., 2013). Physical proximity between performers and audience can support this (Brand et al., 2012). The quality of the experience is influenced by interactions between audience members and the performers, which transform the experience from being passive to active (Dobson and Sloboda, 2014). Technology has enabled communities of fans to upload set lists and photos to online forums and also use Twitter, which helps non-attending fans to feel involved (Bennett, 2012).

Music and Wellbeing in the Older Generation

Across the world, life expectancy is increasing and there are growing numbers of older people. Many live alone and are vulnerable to experiencing depression. In recent years, there has been an increase in research on the role of music in the lives of the older generation. Overall, music becomes more important for the elderly (Gembris, 2008; Laukka, 2007). Participation in a wide range of musical activities provides a source of enhanced social inclusion, enjoyment, personal development and empowerment supporting group identity, collaborative learning, friendship, social support, a sense of belonging, enhanced wellbeing, and access to new social roles and relationships (Allison, 2008; Coffman, 2002; Coffman and Adamek, 2001; Langston, 2011; Sixsmith and Gibson, 2007; Wood, 2010). It is clear that older people gain cognitive, emotional and social benefits from learning to play a musical instrument in a range of different learning environments (Drummond, 2012; Veblen, 2012), even over short periods of time (Bugos et al., 2016). Music-making contributes to psychological wellbeing. It can alleviate loneliness and offer support in coping with the challenges of ageing, providing opportunities for musical progression and enjoyment, and thus adding meaning to life (Forssen, 2007; Lehmberg and Fung, 2010; Saarikallio, 2011). It can provide contentment, satisfaction and feelings of peace, and reduce anxiety and depression. It can reduce the decline in wellbeing so often experienced by the older generation, and foster positive moods and emotions (Lally, 2009; Livesey et al., 2012; Sandgren, 2009).

There are a number of large-scale studies examining the relationship between wellbeing and musical activity in older people. For instance, Jenkins (2011) derived data from the English Longitudinal Study of Ageing—a large-scale, nationally representative survey of those aged 50 and above which contains several wellbeing measures and information on three types of learning: formal courses, music/arts/evening classes and gym/exercise classes. The key finding from this research was that music, arts and evening classes were significantly associated with positive changes in wellbeing. There was no similar relationship between formal courses, gym or exercise classes, and wellbeing. More recently, also using the English Longitudinal Study of Ageing, Fancourt and Steptoe (2018) analysed data from 2,548 adults aged over 55 during a ten-year period, to explore whether membership of different kinds of community groups was associated with wellbeing. Membership of education, arts or music classes was longitudinally associated with lower negative affect and more life satisfaction, while slightly different positive outcomes were associated with membership of religious groups. In a ten-day diary study of 1,042 people aged 13 to 82 years old with music as a hobby, Koehler and Neubauer (2020) showed that need satisfaction and positive affect were higher when participants reported music-making. The satisfaction of basic psychological needs seemed to act as a mediating mechanism between musical activities and wellbeing.

Since the 1980s, a considerable body of research has demonstrated the relationship between actively making music and subjective wellbeing (Lehmberg and Fung, 2010). Adults who participate in active music-making report that it provides valued and worthwhile experiences, while for those in older age it can provide structure and purpose to daily living, enhancing motivation and providing meaning in life (Hallam et al., 2012). It can reduce depression, promote positive emotions and emotional regulation, and provide spiritual experiences (Creech et al., 2014; Dingle et al., 2012). Those working with the older generation in leading music-making have recognised that the older generation are not a homogenous group. Even those who consider themselves to be novice musicians bring to musical activities a mixture of skills, preferences and cultural backgrounds. While they may have reduced capacity in some areas, as musical groups they have a rich knowledge base, and considerable experience and motivation (Dabback and Smith, 2012). Older people tend to be independent learners who want to control their learning, although the extent to which this applies to musical activities varies across groups and the nature of the activities. Group dynamics are important, as they are frequently key to sustaining motivation (Veblen, 2012). Internationally, music educators are increasingly recognising that the social aspects of music-making are important to older adults (Krause and Davidson, 2018) and that there needs to be a change from pedagogy based on expertise training to pedagogy promoting cultural connectedness and sharing.

Exploring a range of issues, Hays and Minichiello (2005) carried out interviews with 52 older Australians to determine the role of music in their lives. Participants were involved with music for much of the time: for instance, listening to music, actively making music, or volunteering (including working in community radio as broadcasters and programmers, in music administration and concert development, or teaching). Listening, performing or composing enabled expression of their individuality and ways of defining themselves. Listening to specific pieces of music led to the recall of events and experiences in their life, along with the emotions associated with them. Music provided a way for them to maintain positive self-esteem, to feel competent and independent, avoid feelings of isolation or loneliness, be distracted from health problems, feel uplifted physically and psychologically, and feel rejuvenated. They used music as an accompaniment to their daily activities, and reported that music helped them feel more competent and motivated. When they were faced with challenging tasks, music provided support and distraction. It reduced anxiety and stress levels, and increased the threshold for pain endurance. Some indicated that music provided them with inner happiness, contentment and peace. It was therapeutic and made them feel more positive about life, as well as more cheerful, hopeful, contented, relaxed and peaceful. Some were moved to tears by music, and listened for the sheer joy and beauty of the experience. Music was able to calm, excite, thrill and entertain them in ways that other things were not able to. For some it became addictive, a way of escaping reality and stimulating their imagination, while the sense of beauty was spiritual in its effect. While this was associated with specific religious beliefs for some, for others it was a personal feeling of being at one with the world. Music provided many benefits which all contributed to their wellbeing. Similarly, participants in the Music for Life project reported engaging in a wide range of musical activities. Questionnaire responses revealed that 96 percent reported listening to recorded music, 81 percent to live music, 80 percent to playing music in the background when they were completing other tasks, 79 percent singing at home, and 49 percent practising at home. They played a wide range of instruments and had a wide range of musical preferences (Creech et al., 2014; Hallam et al., 2012). Laukka (2007) sent a questionnaire to a random sample of 500 community-living older adults aged 65 to 75 years of age in Sweden, to assess their use of music in everyday life including frequency of listening, situations where music was encountered, emotional responses to music and their motives for listening. Different facets of psychological wellbeing were also assessed. The findings showed that listening to music was a common leisure activity and a frequent source of positive emotions. Participants reported using a variety of listening strategies related to emotional functions including pleasure, mood-regulation, and relaxation as well as issues of identity, belonging and agency. Although health status and personality were the most important predictors of wellbeing, some listening strategies were significantly associated with psychological wellbeing.

One strand of research has considered the role of choral singing in promoting wellbeing in older people. For instance, Lamont and colleagues (2018) reported a case study of an older people’s choir over a four-year period, using interviews, focus groups, observations and participatory discussion. Choir members highlighted the individual and interpersonal benefits of being part of the choir. They particularly emphasised the importance of developing social relationships within a supportive community, although musical achievement was also central to the ongoing development of the choir. Five main themes emerged from the data: personal investment and reward, an inclusive community, an always evolving yet fundamentally unchanged environment, a desire to connect, and leadership and organisation. Considering these with reference to Seligman’s (2010; 2011) PERMA framework from positive psychology, it was apparent that social relationships, meaning and accomplishment were particularly important reasons for older people finding singing in a community choir beneficial for wellbeing.

In Tasmania, Langston and Barrett (2008) explored how social capital was manifested in a community choir. Interviews with 27 choir members revealed that the choir provided shared norms and values, trust, civic and community involvement, networks, knowledge resources, and contact with families and friends. Fellowship was identified as a key component in fostering group cohesion and social capital development. Similarly, in England, Coulton and colleagues (2015) evaluated the effectiveness of community-group-singing for a population of 258 older people aged 60 years old or over who either participated in singing or other activities. After three months, significant differences were observed in relation to the mental health components of quality of life, anxiety and depression. After six months, significant differences were observed in mental health in favour of the group-singing. Similarly, Fung and Lehmberg (2016) found that there was a positive impact on quality of life for people in a retirement community who sang together. Joining a group with singing activities as a new musical hobby in later life can provide mental and physical stimulation, positive benefits to mood and increased social interactions. Davidson and colleagues (2014) developed and evaluated an eight-week singing programme with 26 participants aged 70 years or older. There was little impact on health and wellbeing, although the quality of the programme facilitators was an important factor in how the programme was experienced. Pearce and colleagues (2015) followed newly-formed singing and non-singing (crafts or creative writing) adult education classes over seven months. Participants rated their closeness to their group and their affect, and were given a proxy measure of endorphin release, before and after classes at three timepoints: one, three and seven months. The findings showed that, although singers and non-singers felt equally connected by timepoint three, singers experienced much faster bonding in the form of a significantly greater increase in closeness at timepoint one. It seems that singing can have an icebreaker effect in promoting fast social cohesion between unfamiliar individuals. In a single case study, Southcott (2009) focused on a small choir, the Happy Wanderers, formed by a group of older people to perform to residents in care facilities and to sufferers of dementia. Participation in the group enhanced the lives of the members and those of their audiences. Costa and Ockelford (2019) specifically considered the impact of music on audiences. They evaluated a programme of regular concerts and teas for older people. Interview findings showed that the concerts were effective in evoking positive emotions including happiness, relaxation, inspiration, awe and gratitude, whilst negative emotions (such as anxiety and worry) were lessened. These responses were enhanced by the interaction between performers and audience, the high standard of performance and an appropriate repertoire. The opportunity for social contact and interaction relieved loneliness and contributed to participants’ enjoyment.

In a series of studies in the UK, Creech and colleagues (2013; 2014), Hallam and colleagues (2014; Hallam and Creech, 2016) and Varvarigou and colleagues (2012; 2013) researched the relationship between active music-making and subjective wellbeing in older people’s lives. The research comprised three UK case-study sites, each offering a wide variety of musical activities including singing, ensemble participation and song composition. At each site, a sample of people aged over 50, a total of 398, some of whom had recently begun musical activities and others who were more experienced, were recruited to complete questionnaires that assessed quality of life. A control group of 100 completed the same measures. In-depth interviews were carried out with a representative sample, followed by observations of musical activities, focus groups and interviews with the music facilitators. Comparisons were made between older people participating in a wide range of musical and other activities in relation to their questionnaire responses and psychological needs, as well as those participating in the musical activities who were in the third and fourth age groups. The factors that emerged from the analysis of the data were: purpose (having a positive outlook on life), autonomy and control, social affirmation, positive social relationships, competence and a sense of recognised accomplishment. Those participating in the music activities responded more positively than those engaged in other activities. There was also no deterioration in responses in the music groups between those in the third and fourth age groups, as might have been expected with the exception of purpose in life. The interviews revealed cognitive benefits including challenge, the acquisition of new skills, a sense of achievement, and improvements in concentration and memory. Health benefits included increased vitality, improved mental health and mobility, and feelings of rejuvenation, while emotional benefits included protection against stress and depression, support following bereavement, a sense of purpose, positive feelings, confidence and opportunities for creativity.

There is considerable evidence that older adults experience a myriad of psychosocial benefits from learning to play a musical instrument, even when starting to play as novices and when receiving training over relatively short-term periods (Jutras, 2006; Roulston et al., 2015). Older adults frequently cite the ensemble nature of musical activities as a motivating factor to continuing engagement in learning to play an instrument (Roulston et al., 2015). The social aspects of ensembles offer wellbeing benefits through the development of new relationships and decreasing isolation. Singing and playing seem to be important to the elderly as they can enhance emotional self-regulation, emotional expression and relaxation. They help to reduce loneliness and provide experiences of togetherness, company and belonging, help to strengthen self-concept and self-understanding, and provide enjoyment, beauty, challenge and meaningful content to life. Focusing on the learning of keyboard, guitar, recorder or djembe drums—taught individually or in small groups—or creative musical activities over a ten-week period with 98 individuals over the age of 50 with no or very little prior musical experience, Perkins and Williamon (2014) concluded that engaging in such activities offered significant wellbeing benefits, particularly enhancing behaviours which promoted good health. Interviews with a subgroup of 21 participants revealed that engaging with the musical activities enhanced wellbeing through subjective experiences of pleasure, enhanced social interactions, musically nuanced engagement in day-to-day life, fulfilment of musical ambition, the ability to make music, and self-satisfaction through making musical progress.

Learning to play a musical instrument may also be effective for improving fine motor skills. Sensorimotor function generally declines with age, and performance of the upper limbs in visuomotor tasks is also subject to this decrease. The tasks required in musical instrument training—employing sensory, motor and multimodal brain regions—have been shown to stimulate brain plasticity (see Chapter 3; Altenmuller and Schlaug, 2015; Rogenmoser et al., 2018). Piano-playing, in particular, trains both coupled movements across the fingers and individuated finger movement (Furuya and Altenmuller, 2013) but it is unclear if this type of training is useful for maintenance or improvement in the context of ageing. Preservation of domain-general fine motor skills may also benefit healthy older adults, supporting the maintenance of the skills required for numerous daily tasks involved in independent living.

In a series of studies, Bugos and colleagues (2007; 2016; Bugos and Kochar, 2017) demonstrated that healthy older adults experienced significant improvements in cognitive measures, particularly trail-making tasks and digit-span tests, as a result of piano training programmes. They also showed that the intense piano training of 17 healthy community-dwelling adults aged 60 to 85 years old enhanced musical self-efficacy, although not general self-efficacy or cortisol levels. Bugos and Cooper (2019) examined the effects of music interventions on bimanual coordination and cognitive performance in healthy older adults aged 60 to 80 years old. One hundred and thirty-five participants completed motor measures and a battery of standardised cognitive measures, before and after a 16-week music training programme with a three-hour practice requirement. Participants were allocated to either piano, fine motor training or percussion instruction, gross motor training, or music listening. There were significant enhancements in bimanual synchronisation and visual scanning working memory abilities for fine- and gross-motor training groups, as compared to listening to music. Piano training significantly improved motor synchronisation skills as compared to percussion instruction or music-listening. Reflecting on the existing research, Bugos (2014) developed a model suggesting how community music programmes and musical training could be integrated to lead to successful ageing. Similarly, Seinfeld and colleagues (2013) showed significant improvement in cognitive measures for a group of older adults involved in piano training programmes as compared to other leisure activities (for instance, exercise or painting). Thirteen participants received piano lessons and undertook daily training for four months, compared to 16 age-matched participants who acted as a control group and participated in other types of leisure activities (physical exercise, computer lessons or painting lessons). There was a significant improvement in the piano training group in relation to executive functions, inhibitory control and divided attention. There was also a trend indicating an enhancement in visual scanning and motor ability. Piano lessons also decreased depression, induced positive mood states, and improved the psychological and physical quality of life. Overall, playing the piano and learning to read music can be a useful intervention in older adults to promote cognitive reserve and improve subjective wellbeing. In an ongoing study, James and colleagues (2020) explored the outcomes of piano instruction or musical listening awareness on two sites in Hannover and Geneva with 155 retired healthy adults aged 64 to 78 years old. Participants receive weekly training for one hour over a 12-month period. The outcomes being assessed relate to cognitive and perceptual motor aptitudes, as well as structural neuroimaging and blood-sampling. MacRitchie and colleagues (2020) examined the effects of a ten-week piano training programme on healthy older adult novices’ cognitive and motor skills, in comparison to an inactive waiting-list control group. Fifteen participants completed piano training, led by a music facilitator in small groups. Quantitative data from a battery of cognitive and motor tests was collected before and after training, with further post-test data from the control group. Qualitative data included weekly facilitator observations, participant practice diaries, and an individual, semi-structured, post-experiment interview. The findings demonstrated evidence of a strong positive impact of training on a trail-making test, indicating improved visuomotor skills. Moderate evidence for the negative impact of training on a different section of the trail-making test was also found, suggesting no benefit of cognitive switching. Qualitative results revealed that the group learning environment motivated participants to play in musical ensembles and to socialise. Motivation was optimal when all participants were happy with the chosen repertoire. Participants reported that they were motivated by learning to play familiar music and when the facilitator observed that groups had formed cohesive bonds.

As we saw in Chapter 2, brain plasticity is possible in adulthood and in the elderly, following relatively short-term musical training (Herdener et al., 2010; Lappe et al., 2008; 2011). Training programmes requiring intensive multisensory, cognitive and motor activities (for instance, piano lessons) can improve working memory, perceptual and motor skills, and delay age-related decline in speech perception (Parbery-Clark et al., 2011; 2012), non-verbal memory, executive processes (Hanna-Pladdy and MacKay, 2011) and dementia (Verghese et al., 2003). Supporting this, comparisons of 42 professional, 45 amateur and 38 non-musicians by Rogenmoser and colleagues (2018), using brain imaging to calculate a brain age for each participant, found that being a musician had a positive impact on brain-age scores. Musicians in general exhibited lower brain-age scores than non-musicians, suggesting a general age-decelerating effect of music-making on the brain. Further, there was a stronger age-decelerating effect in the amateur musicians, perhaps because the multisensory, motor and socioaffective experiences of musical activity enriched their lives in addition to other activities. For the professional musicians, brain plasticity may be maladaptive. The extensively rehearsed and highly specialised repetitive sensorimotor activities and stressful public performances may result in a less enriched environment and lead to negative health effects.

There has been a focus in some research on creative activities, usually song composition. For instance, Waddington-Jones and colleagues (2019) analysed video-recall interviews and questionnaires, to evaluate the impact of participation in collaborative composition workshops on the subjective and psychological wellbeing of older adults. The analysis revealed that all of the dimensions of the PERMA framework for subjective and psychological wellbeing were met. For older adults, collaborative composition encouraged social interaction with others with shared interests, increased positive affect, enhanced self-esteem and allowed older people to express themselves. Similarly, Baker and Ballantyne (2013) investigated whether group song-writing and performing affected perceptions of quality of life and feelings of connectedness in a community of retirees. Thematic analysis of data transcripts from focus groups and written questionnaires from participants and the students involved in the project indicated that the programme stimulated enjoyment, positively affected emotions and improved wellbeing. Participants experienced enhanced connection with one another, as well as with others in the broader community, and a sense of accomplishment, meaning and engagement in creating and performing their own songs. In a similar project, where professional musicians worked with a small group of older people to compose individual pieces of music, Habron and colleagues (2013) demonstrated enhanced wellbeing through facilitated control over musical materials, opportunities for creativity and the development of identity, the validation of life experiences, and social engagement with other participants and the professional musicians. The results emphasised the importance of occupation as essential to health and wellbeing in the later stages of life. Creech and colleagues (2020) focused on the role of creativity in promoting wellbeing. In a review of 23 articles, they concluded that creativity in participatory music-making was underpinned by social engagement, collaboration and inclusivity. Opportunities for creative expression offered a range of benefits relating to quality of life, including positive emotions, engagement, relationships, a sense of meaning and accomplishment.

An innovative programme in rural Ontario was designed to address social isolation among older people through matching participants with trained volunteers. Both then worked together over ten sessions in their home setting to create expressive art, which may have involved music. Evaluating the programme using interviews, MacLeod and colleagues (2016) found enhanced wellbeing in the older adults and the volunteers, particularly in terms of relationships, personal development and creating meaning. The impact of the intervention extended beyond the programme’s duration. In an exclusively musical programme which used similar methods, Dassa (2018) analysed 43 interviewers’ essays, documenting meetings between an interviewer and an elderly person written over four years. The mutual musicking elicited remote memories from childhood, adolescence and adulthood, and emotionally impacted both parties. Mutual musicking revealed new and unfamiliar facets of the participants. The findings suggested that creating a musical autobiography interview through a process of music and reminiscence strengthened the older person’s sense of self-identity, illuminated hidden aspects and also changed attitudes toward the elderly. Also studying the concept of reminiscence, Kruse (2021) explored the ways that older adults reminisced about music participation over the course of their lives. Six community musicians participated in the interviews and worked with a life-review tool. Two hundred and twenty-five reminiscences reflected healthy ageing and satisfaction, including self-acceptance, valuable life lessons and the reconciliation of life events, although some participants were troubled by strained parental relationships and bittersweet associations with music.

Some research has focused more broadly on music-related activities: for instance, dancing. Focusing on depression in the elderly, Rummy and colleagues (2020) carried out a systematic review of 13 articles. Some studies used individual therapy, while others combined music therapy with other activities such as singing, dancing and lyric-writing. The time spent varied from two weeks to six months, with one or two sessions weekly, each with a duration of 30 to 60 minutes. They concluded that music therapy was effective in reducing depression. Also studying the impact of music indirectly through dance, Murrock and Graor (2016) found that the 16 disadvantaged adult participants who completed a 12-week dance intervention developed a sense of belonging and group identity, which may have maintained group involvement and contributed to reducing depression and social isolation.

There has been some interest in the way that music technology might support wellbeing in the older generation. For instance, Engelbrecht and Shoemark (2015) carried out a mixed-method feasibility study investigating the acceptability and efficacy of using iPads compared to traditional musical instruments with older adults living privately in the community. Five women aged 71 to 96 years of age were recruited from a community-based day-respite centre in Brisbane, Australia. Participants were randomly assigned to either a traditional musical instrument or an iPad group, and engaged in five sessions of activity-based music therapy. Participants completed journal entries following each session to detail their experiences, and were assessed for levels of perceived social isolation and global self-esteem before and after the intervention. The use of iPads was acceptable to the group. Learning was central to all sessions, but there were differences in mood outcomes and emotional communications. Playing on an iPad resulted in greater creativity and freedom. There were no significant differences in social isolation or self-esteem between groups or over time. Both iPad and traditional instrument interventions developed social cohesion group identity and positive self-concept. Overall, the findings showed that technology can be an acceptable and potentially successful tool for use in music therapy with older people living in the community. Creech (2019) supported these findings in a literature review of the intersection between music, technology and ageing. Of the 144 papers screened, 18 were retained. Ten focused on using technology to support musicking in the form of listening, reflecting and interpreting, while five explored the utility of technology in promoting singing or playing instruments, and a further three were focused on music and movement. Overall, the literature suggested that older people, even those with complex needs, were capable of and interested in using music technologies to access and create personally meaningful music. Similarly, Poscia and colleagues (2018) reviewed the effectiveness of existing interventions for alleviating loneliness and social isolation among older people. The findings from 15 quantitative and five qualitative studies suggested that new technologies and community-engaged arts might be able to tackle social isolation and loneliness among older individuals.

While the wellbeing of older people is important, it is also important to consider the wellbeing of those caring for them. Considering the role of carers and their patients, Ascenso and colleagues (2018) studied 39 participants in a series of community drumming programmes. The outcomes were assessed through semi-structured interviews and focus groups at the end of each programme. Emotional, psychological and social dimensions of wellbeing emerged for both patients and carers.

Music, Wellbeing and the COVID-19 Pandemic

There have been a number of research projects which have considered the role of music in offering support to people during the COVID-19 pandemic. One strand of research has explored the use of music in families during lockdowns. For instance, in the USA, Cho and Ilari (2021) studied how parents with young children used recorded music in their everyday lives during the pandemic. Nineteen mothers of children aged 18 months to five years strategically managed the sonic home environment over a period of one week, based on resources provided by the researchers in response to their children’s mood and state. A total of 197 episodes were collected of children’s engagement with recorded music. The findings showed that, while mothers utilised music to fulfil various emotional needs, they tended to use it most to maintain or reinforce their child’s positive mood, rather than to improve a negative mood. Mothers reported various ways that their young children engaged with music and stated that their strategic approaches to using recorded music seemed to help their children feel less distressed and more happy, thus reducing the stresses of parenting. Similarly, in the USA and Canada, Steinberg and colleagues (2021) utilised an online questionnaire to assess the use of music in the homes of young children and their parents, and its relationship with parents’ attachment to their child. Musical activity was high for both parents and children. Parents reported using music for emotional regulation and to socially connect with their children. The extent of parent-child musical engagement was associated with attachment. Overall, music may be an effective tool for building and maintaining parent-child relationships during a period of uncertainty and change. In Brazil, Ribeiro and colleagues (2021) explored how social distancing during the COVID-19 pandemic altered families’ music-related behaviours with children aged three to six years old, as well as caregivers’ levels of wellbeing and stress. One hundred and eighty-eight caregivers participated in an online survey which showed significant changes in families’ dynamics: parents, especially mothers, spent more time in childcare, with a substantial decrease in caregivers’ wellbeing. There were changes in caregivers’ and children’s musical activities at home during social distancing, including an increase in child-only and shared caregiver-child musical activities. Sociodemographic factors and the child’s disability status significantly influenced musical engagement.

Through a transhistorical comparison of the musical activities of the Milanese during an outbreak of plague in 1576 and the musical activities observed during the COVID lockdowns in 2020 (including balcony-singing and playlist-making), Chiu (2020) discussed how music fulfils its functions of mood regulation and social cohesion in times of pandemic and social isolation. There is much evidence from the internet and news outlets of the important role that music, communicated through social media, has played in supporting people during the COVID-19 pandemic. A number of research projects have also been undertaken, typically through the use of online questionnaires. For instance, Granot and colleagues (2021) administered an online questionnaire in 11 countries: Argentina, Brazil, China, Colombia, Italy, Mexico, the Netherlands, Norway, Spain, the UK and the USA. They received 5,619 responses. Participants rated the relevance of wellbeing goals during the pandemic, and the effectiveness of different activities in obtaining these goals: enjoyment, venting negative emotions and self-connection. For diversion, music was as effective as entertainment, while it was second best in creating a sense of togetherness, after socialisation. This was evident across different countries and genders, with minor effects of age on specific goals, and a clear effect of the importance of music in people’s lives. Cultural effects were generally small and occurred mainly in the use of music to obtain a sense of togetherness. Culture moderated the use of negatively-valenced and nostalgic music for those with higher levels of distress.

Carlson and colleagues (2021) also used an online survey with a Likert scale and free-text responses, to establish how participants were engaging with music during the first wave of the pandemic. The findings showed that the extent of music-listening behaviours were either unaffected or increased. This was especially true of listening to self-selected music and watching live-streamed concerts. There was a relationship between participants’ use of music for mood regulation, their musical engagement, and their levels of anxiety and worry. A small number of participants described having negative emotional responses to music, the majority of whom also reported severe levels of anxiety. In Spain, also using an online survey disseminated to the general population and groups of musicians, Martinez-Castilla and colleagues (2021) analysed the impact of personal and contextual factors on the perceived efficacy of musical behaviours in fulfilling wellbeing-related goals during lockdown. Responses were received from 507 people. Personal factors had an impact on music’s efficacy, but not contextual variables related to COVID-19 itself. The youngest respondents and those with musical training reported the highest efficacy of music for enhancing wellbeing, but overall, music’s importance was the main predictor of its perceived efficacy. People who were emotionally more vulnerable during lockdown, due to either a strong impact on their daily lives or lower resilience, perceived greater benefits from engagement with music. In Brazil, also using an online questionnaire, Ribeiro and colleagues (2021) explored how music was used during lockdowns and whether it helped individuals, especially those with severe depression. Nearly 500 people aged 18 and over responded. Four types of music-listening functions were identified: negative mood management, cognitive functioning, positive mood management and physical involvement. Those with severe depression were more likely to use music for each of these functions—in particular, to manage negative moods. Most respondents used music-listening to cope with and regulate their moods. Again, using an online questionnaire, Gibbs and Egermann (2021) explored the nature of music-induced nostalgia. Five hundred and seventy participants listened to a self-selected piece of music designed to induce nostalgia, which they had listened to three months prior to lockdown. They reported the emotions and the memories induced. There were significant differences in the affective and narrative content of nostalgic music-listening in relation to which emotional regulation strategy was used. Employing nostalgic music-listening as a form of approaching difficult emotions was shown to have a positive impact on wellbeing.

In Italy, Corvo and De Caro (2020) studied spontaneous singing during the COVID-19 pandemic. Overall the Italians spent a great deal of time in lockdown. From a mental wellbeing point of view, it was difficult to adapt to internment and movement controls. The lack of freedom and opportunities to meet with friends and relatives had a serious impact on wellbeing. Almost immediately after the first lockdown began, the silence in Italian cities was broken by singing. It was carried out in various ways. In some places, quite recent songs with a strong emotional impact were sung, while in others, old songs strongly connected to Italian culture (such as the national anthem) were chosen. The balconies and windows in the streets of the cities were animated with people of all ages enjoying these moments of social cohesion and emotional exchange. Videos were made instinctively and shared through social media by individuals, showing moments of strong union, in which the sense of loneliness was (to some extent) forgotten. These singing networks were completely spontaneous and showed singing used as a coping strategy and to improve the sense of cohesion. The songs chosen reflected individuals’ identities and helped avoid feelings of loneliness and enhance mood. After two or three weeks, the number of people singing reduced, but revived later. Music clearly provided a means of demonstrating social solidarity which helped communities in a time of crisis. Similarly, Calvo and Bejarano (2020) reported on music in Spain during the crisis, where during the first weekend of confinement, a growing number of individuals started to play music after the collective applause to express gratitude towards health workers and doctors. This involved professional musicians but also many amateurs. Performances were posted on social media. Singalongs, balcony to balcony, classical music duos or serenading with traditional instruments expressed a social message that transcended the quality of the music performed. They set up a database of 150 individuals who had played or sung on their balconies at least twice. They identified performers in places with strong regional identities, such as Galicia or the Basque Country, and also with strong traditions of band music, such as Valencia. They also undertook 51 telephone interviews. They asked about confinement, why people played, the selection of repertoire and how neighbours reacted. In many cases, performers reacted to informal or formal petitions to sing or play by close relatives, next-door neighbours, or even by brass bands and orchestras. A professional association of music teachers set up an online challenge which invited music teachers to simultaneously play a different score each day. Music teachers spoke about these challenges as a very persuasive reason to keep on playing, perhaps through fear of breaking relationships of trust and respect with peers in their profession. Despite differences in professional background, respondents quoted personal reasons for playing from balconies. They talked about the need to provide a break to the tedious life of confinement. Musicking provided children with activities and gave students a reason to continue practising. Local media reported that a music teacher organised balcony-to-balcony study sessions of txistu—a traditional instrument popular in the Basque Country that resembles a flute—with students who happened to live nearby. The dominant theme emerging from the data was the need to create bonds with neighbours and also to help others. Professional musicians saw this as their duty as artists. In other cases, performers simply wanted to do something for other people. A further theme was the presentation of music as a stress reliever, a way to cope with anxiety, loneliness and the pain associated with not being able to meet loved ones. Many musicians started playing on March 19^th, Father’s Day in Spain, as a way to express love and affection. Musicking helped with the celebration of birthdays in an interesting process where private rituals became a vehicle to connect with neighbours. Helping others was the most common expression. Performers wanted to cheer up people hospitalised in nearby mental health centres, to remind senior neighbours that there was someone out there and to cheer children up. The realisation that music had the potential to do good transformed what was meant as a one-off act into a daily routine.

Also in Spain, Cabedo-Mas and colleagues (2021) carried out a survey on the use of music during the pandemic. A total of 1868 Spanish citizens responded. The findings indicated that, during lockdown, respondents perceived an increase in the time they devoted to musical activities such as listening, singing, dancing or playing an instrument. They also reported using music to cope with the lockdown, finding that it helped them to relax, escape, raise their mood or keep them company. The findings suggested an improvement in their perception of the value of music in personal and social wellbeing during the lockdown, although there were significant differences in the use and perceptions of music according to respondents’ personal situations. Age and feelings of vulnerability may have led to more conservative uses of musical practice and to more moderate perceptions of the positive values of music. Cabedo-Mas and colleagues also pointed out the importance of playlists during isolation because of their social functions. As more and more countries entered lockdown, Spotify reported on March 30^th an increase in collaborative playlist-making, which allowed people to connect over shared music and have virtual jam sessions together. In the same media release, Spotify also noted that their users were sharing more content on their social networks than usual, so friends and followers would know what they were doing. One group of songs that saw spikes in streaming figures were those used in balcony performances, the recordings of which circulated widely on social media. According to the March 20^th report by Spotify, streams of two of the songs sung by Italian flash mobs Abbracciame and Azzurro had increased over 700 percent. In Spain, streams of the song Resistiré increased by over 400 percent. ‘Abbracciame’ (‘Embrace Me’) by Andrea Sannino first released in 2015, has since earned the gold certification by Federazione Industria Musicale Italiana in 2020, with 35,000 copies sold. At that time, it had received over 41 million views on YouTube and seven million streams on Spotify. Undoubtedly, balcony-singing had an immense impact on musical culture during the lockdowns and will remain, for many, one of the musical practices indelibly associated with that period.

During lockdowns, participants in musical activities such as flash mobs or online ensembles, as well as their spectators, frequently reported the alleviation of stress and the feeling of connectedness as a result of their musical engagement. Erica Marino was a participant in one of the earliest balcony flash mobs in Benevento, the video of which went viral in early March (Cozzolino, 2020). When asked about the messages flooding in from all over Italy after the video of the music-making was widely shared on social media, Marino reported that viewers expressed gratitude because they perceived a message of hope and positivity from viewing it, as most social networks only contained devastating news. Balcony-singing has deep roots in Italy. In 1576, when the Milanese plague grew more deadly and public processions came to an end, Borromeo relocated the ritual inside private homes, decreeing that church bells across the city were to be rung seven times a day and, while the bell was rung, litanies or supplications were to be sung or recited at the direction of the bishop. This was to be performed in such a way that one group sang from the windows or the doors of their homes, and then another group sang and responded in turn. COVID-19 seems to have revived this tradition. Mak and colleagues (2021) collected data from 19,384 participants participating in the UK COVID-19 social study at University College London to investigate who engaged with the arts at home during lockdown, how this engagement differed from patterns of arts engagement prior to COVID-19, and whether home-based arts engagement was related to people’s ability to cope with their emotions during lockdown. Demographic factors, socioeconomic status, psychosocial wellbeing, health conditions, adverse events, worries and coping styles were considered. Four types of home-based arts engagement were identified: digital arts and writing, musical activities, crafts and reading for pleasure. The strongest predictors of engagement were age, educational attainment, social support, and emotion-focused or supportive coping styles. Younger adults aged 18 to 29, non-key workers, people with greater social support, people who had lost work, those who were worried about catching the virus, and those with an emotion-focused, problem-focused or supportive coping style were more likely to have increased arts engagement during lockdown. Arts activities were used as approach and avoidance strategies to help cope with emotions, as well as to help improve self-development. Overall, the findings suggested that, while some people who engaged in the arts during the pandemic were those who typically engaged under normal circumstances, the pandemic created new incentives and opportunities for others to engage virtually. The research also highlighted the value of the arts as coping tools during stressful situations.

Some research has explored how online music-making has developed as a result of the lack of opportunities for live music-making during the pandemic. For instance, MacDonald and colleagues (2021) studied the Glasgow Improvisers Orchestra’s virtual, synchronous improvisation sessions through interviews with 29 participants. Sessions included an international, gender-balanced and cross-generational group of over 70 musicians, all of whom were living under conditions of social distancing. The sessions were recorded using Zoom. The findings showed that the sessions provided opportunities for artistic development, enhanced mood, reduced feelings of isolation, and sustained and developed community. Improvisation facilitated interaction and also allowed the technological affordances of software and hardware to become part of the artistic collaboration. The domestic environment merged with the technology to create what the authors described as ‘The Theatre of Home’. Similarly, Daffern and colleagues (2021) studied virtual choirs in the UK through an online survey of 3,948 choir members and facilitators. The findings showed that three virtual choir models were employed: multi-track, whereby individuals recorded a solo which was mixed into a choral soundtrack; live-streamed, where individuals took part in sessions streamed live over social media; and live teleconferencing, for spoken interaction and or singing using teleconferencing software. Responses to open questions revealed several issues, including the practicalities of participation, the continuation of the choir, the responsibility of maintaining the choir, how the choir contributed to a sense of wellbeing, and social aspects reflecting a sense of community and social identity. Musical elements were also reported, particularly how the value of the musical experience changed with the virtual models, the possibility of co-creation through singing, but also a sense of loss of singing together in real time.

Sacred Harp singers from all over the world gather weekly to sing a collection of shape-note songs first published in 1844, The Sacred Harp (Morgan-Ellis, 2021). This tradition is highly ritualised, and plays an important role in the lives of participants. As lockdowns were implemented, groups of Sacred Harp singers independently devised a variety of means by which they could sing together online using Zoom, zinging, Jamulus, jamzinging, and Facebook Live stringing. These developments were undertaken rapidly and creatively, indicating the importance participants attached to singing. Twenty-two interviews were conducted with participants and revealed that online singing practices had reshaped the Sacred Harp community. Many singers who previously did not have the opportunity to participate now did so, while others lost access. As geographical barriers disintegrated, singing organisers had to find ways to maintain local identity. The online community of singers in the digital realm was stable but not identical to the community that predated the pandemic. Online singing was meaningful to participants, and provided continuity in their personal and communal practice. It allowed participants to access and celebrate their collective memories of the Sacred Harp community, carry out significant rituals and continue to grow as singers. No single modality replicated the complete Sacred Harp singing experience, but each allowed individual participants to access many aspects that were most meaningful to them. Also focusing on communal singing, Dowson and colleagues (2021) studied the impact of the pandemic on existing dementia singing groups and choirs. Over 50 examples of online musical activities were identified. Sessions had to be adapted to the limitations of the technology rather than technological difficulties being overcome. Accessibility, digital safety and the wellbeing of participants were important considerations, but overall the pandemic prompted innovative approaches to delivering activities and interventions. People with dementia and their carers adapted rapidly to the changes. Online music met a clear need for social connection and cognitive stimulation. It also offered some advantages which will remain even when COVID-19 restrictions are relaxed.

In a cross-sectional survey of 257 adults who participated in instrumental, singing or dance groups, Draper and Dingle (2021) explored the impact of face-to-face versus virtual music-making during the pandemic. Participants rated the extent of their group identification and the extent to which their psychological need satisfaction was met retrospectively for their music group in face-to-face mode, and then in adapted online mode, along with their mental health. The findings showed that instrumental groups were less commonly adapted to virtual mode than singing and dance groups. Group identification and average psychological need satisfaction scores were significantly lower for groups in virtual mode than in face-to-face mode. However, group identification and psychological need satisfaction remained high, which suggests that virtual music groups may be beneficial when face-to-face music-making is not possible.

As concerts have been recorded rather than live during the pandemic, Belfi and Colleagues (2021) investigated differences in aesthetic judgments of live as opposed to recorded concerts, and whether these responses varied based on congruence between the musical artist and the piece. Thirty-two individuals made continuous ratings of the pleasure that they experienced during a live concert or while viewing an audiovisual recorded version of the same concert given by a university band and a United States army band. Each band played two pieces: a United States patriotic composition and a non-patriotic one. The findings showed that, on average, participants reported more pleasure while listening to pieces that were congruent with the band playing them (patriotic for the army band and non-patriotic for the university band). These findings did not change whether the performance was live or recorded. It seems that virtual concerts are a reasonable way to elicit pleasure from audiences when live performances are not possible. Focusing on the use of collaborative playlists, during the pandemic Harris and Cross (2021) developed an experimental procedure to study whether the perceived presence of a partner during playlist-making could elicit the observable correlates of social processing. Preliminary findings suggested that, for younger individuals, some of the social processes involved in joint music-making were elicited even by an assumption of a virtual co-presence.

One strand of research has focused on the way that undergraduates used music during the pandemic. Hurwitz and Krumhansi (2021) discussed the concept of listening-niche referrals to the contexts in which people listen to music, including the music they are listening to, with whom, when, where and with what media. They investigated undergraduate students’ music-listening niches in the initial COVID-19 lockdown period, four weeks immediately after the campus shut down, and then when returning for a hybrid semester. Participants provided a list of their most frequently listened to songs and identified one that seemed most associated with that time period and why it was relevant. Three clusters of themes emerged from the data: emotional responses, memory associations and discovery of new music. Overall, the pandemic led to more frequent listening in general and on Spotify, with no differences between lockdown and the new normal. Listening companions shifted from family members to significant others, and finally to other friends and roommates. Overall, the implementation of strategies to manage COVID-19 increased listening and changed its context.

Vidas and colleagues (2021) surveyed 402 first-year Australian university students, domestic and international, to examine the effectiveness of music-listening during COVID-19. Songs that participants were asked to nominate as helping them to cope with pandemic stress tended to be negative in mood. Listening to music was among the most effective coping strategies, and was as effective as exercise, sleep and changing location. Its effectiveness was related to enhanced wellbeing but not specifically to the level of stress caused by the pandemic. International students experienced higher pandemic stress levels, but similar levels of wellbeing to domestic students. Overall, listening to music remained an effective strategy for maintaining wellbeing. Also in Australia, Krause and colleagues (2021) assessed students’ media use throughout the early stages of the COVID-19 pandemic and determined whether media use was related to changes in life satisfaction. One hundred and twenty-seven participants were asked to complete online questionnaires, capturing pre- and during-pandemic experiences. The findings indicated that media use varied substantially throughout the study period, and at the within-person level. Life satisfaction was positively associated with listening to music and negatively with watching TV, videos or movies. The findings highlighted the potential benefits of listening to music during periods of social isolation.

The Impact of the Pandemic on Music Professionals

A further strand of research has focused on the ways that musicians have coped during the pandemic. For instance, Onderdijk and colleagues (2021) collected responses from 234 musicians in Belgium or the Netherlands. The findings showed a decrease of 79 percent of live music-making in social settings during lockdown and an increase of 264 percent for online joint music-making. Respondents depending on music-making as their main source of income explored online methods significantly more than those relying on other income sources. Most respondents were largely or even completely unaccustomed to using specialised platforms for online joint music-making, and mainly used video conferencing platforms such as Zoom and Skype when playing together virtually. These were not often employed for synchronised playing and were generally reported to be unable to deal with latency issues. There was an increase of 93 percent in the use of alternative remote joint music-making methods—for instance, recording parts separately and subsequently circulating these digital recordings.

In the UK, Spiro and colleagues (2021) collected data from 385 performing-arts professionals. The pandemic led to a substantial reduction in work and income, leading 53 percent to report financial hardship. Eighty-five percent reported increased anxiety and 63 percent being lonelier than before the crisis. While 61 percent sought financial support, only 45 percent asked for support for health and wellbeing. Perceived financial hardship was associated with lower wellbeing and higher depression and loneliness scores. There were positive associations between self-rated health and wellbeing and lower depression scores. Responses to open questions identified several overarching themes characterising the effects of lockdown:

loss of work and income, financial concerns, and uncertainties for the future;
the constraints of lockdown working, including challenges of working at home, struggles with online work and skill maintenance, and caring responsibilities;
loss and vulnerability, including reduced social connections, lack of support, feelings of loss and grief, and concern for others;
detrimental effects on health and wellbeing, including anxiety, low or unstable mood, poorer physical health and lack of motivation; and
professional and personal opportunities, including coping well or living more healthily, more time and less pressure, new possibilities and activities, enhanced social connections and new skills.

Overall, lockdown had profound negative effects on performing-arts professionals, but also presented some opportunities. Also in the UK, Cohen and Ginsborg (2021) studied the impact of COVID-19 on professional freelance musicians, comparing those in the middle of their performing careers (aged 35 to 45) with older players (aged 53 and over). Semi-structured interviews were carried out over Zoom with 24 freelance, self-employed orchestral musicians. Thematic analysis identified common issues: the loss of a much-loved performing career, missing music-making and colleagues, and anxiety about the future of the music profession—although there were differences in relation to identity as a musician, the extent of anxiety about finance, the extent of emotional distress, attitudes toward practising and engaging in collaborative music-making, and confusion over future career plans. Music students seemed to be less affected by the pandemic than professional musicians and showed no significant differences in satisfaction with life, studying or the impact of the pandemic when compared with students studying sports (Habe and colleagues, 2021).

Focusing on music teachers in Australia, De Bruin (2021) studied how COVID-19 impacted on the way they taught, engaged and interacted with students across online platforms. The findings from interviews showed that the adopted teaching approaches fostered connection, empathy and relationship-building, guiding students in slower and deeper learner-centred approaches, using pedagogical practices that reinforced and promoted interpersonal connectedness in and through musical experience and discovery.

The COVID-19 pandemic has impacted on the way that music therapists across the world have undertaken their work, particularly in relation to the use of technology (Agres et al., 2021). Cole and colleagues (2021) investigated the transition of neurological music therapy services from in-person to telehealth. An online survey was distributed to neurological music therapy affiliates worldwide. Sixty-nine therapists fully participated in the survey. The findings showed that there was no change in the overall number of clinical hours retained over telehealth, and there was an association between more frequent telehealth usage and the perceived likelihood of using telehealth in the future. All types of therapy transferred to telehealth, although there were some specific implementation changes. Overall, therapists spent fewer hours working with telehealth compared to in-person therapy, regardless of the employment setting. Technological challenges were drawbacks, but major benefits included the ability to continue providing therapy when in-person sessions were not possible, increased accessibility for remote clients, and positive outcomes relating to increased caregiver involvement.

Overview

The evidence set out in this and previous chapters shows clearly that music can benefit the hedonic (feeling good) and eudaimonic (functioning well) components of wellbeing throughout the lifespan, although it has particular impact in adolescence and older age. Overall, there are many possible benefits to wellbeing and physical health from engaging with music, either through listening to or actively making music. These benefits occur through the impact of music on arousal levels, moods and emotions, the social aspects of group music-making, its role in personal development, and in some cases, directly through music therapy. For the benefits of listening to be realised, the listener needs to like the music. Music imposed by others, if not to an individuals’ taste, can create tension and distress. For those prone to depression, engaging deeply with music which is sad or focuses on negative life experiences, particularly when shared with others, can have negative effects. For the social and personal benefits of making music to be realised, the quality of the interpersonal interactions between participants and those facilitating the musical activities is crucial. The quality of the teaching, the extent to which individuals are successful, and whether overall it is a positive experience contribute to whether there are positive outcomes. If the musical experience is negative in any respect, any possible positive effects will be marginal or non-existent. The way that music has been used in the COVID-19 pandemic illustrates clearly how important it is in people’s lives and the extent to which it can support wellbeing in a myriad of ways in stressful situations. Ongoing technological advances continue to make listening to or making music more accessible to a greater number of people, providing more opportunities for promoting wellbeing.